摘要
目的探讨临床Ⅲ~Ⅳ期口腔鳞状细胞癌(OSCC)患者术后复发的危险因素和复发患者的预后状况。方法回顾性分析2012年1月~2018年6月山西医科大学第一医院口腔颌面外科诊治的230例临床Ⅲ~Ⅳ期口腔鳞状细胞癌患者的资料,并对106例术后复发的患者进行研究。采用单因素和多因素Logistic回归分析研究影响患者术后复发的危险因素,以及单因素和多因素生存分析研究复发患者的预后状况。结果该组患者术后的总复发率为45.3%,单因素Logistic回归分析显示,pN分期、病理分化、淋巴结比率和神经侵犯是影响Ⅲ~Ⅳ期OSCC患者术后复发的危险因素(P<0.05)。多因素Logistic回归分析显示,淋巴结比率和神经侵犯是影响Ⅲ~Ⅳ期OSCC患者术后复发的独立危险因素[OR(95%CI)分别为3.012(1.113~8.148)和0.346(0.138~0.866),P<0.05]。复发患者的总体生存率(OSR)显著低于未复发患者(3年OSR 39.6%vs 92.8%,5年OSR 21.9%vs 82.6%,P=0.000)。单因素生存分析显示,pN分期和神经侵犯是影响复发患者预后的危险因素(P<0.05)。多因素生存分析显示,pN分期和神经侵犯是影响复发患者预后的独立危险因素[HR(95%CI)分别为1.229(0.996~1.517)和0.490(0.266~0.901),P<0.05]。结论Ⅲ~Ⅳ期OSCC患者复发率较高且复发后预后不佳,淋巴结比率和神经侵犯是影响复发的不良特征,而pN分期和神经侵犯与复发患者的预后密切相关。
Objective To discuss postoperative recurrence risk factors and the prognosis of patients in clinicalⅢ-Ⅳperiod of oral squamous cell carcinoma(OSCC)with recurrence.Methods From January 2012 to June 2018,230 patients with stageⅢ-Ⅳoral squamous cell carcinoma in the department of oral and maxillofacial surgery of The First Hospital of Shanxi Medical University were retrospectively analyzed,and 106 patients with postoperative recurrence were studied.Univariate and multivariate logistic regression analysis was used to study the risk factors for postoperative recurrence of patients.Univariate and multivariate survival analysis wasused to study the prognosis of recurrent patients.Results The total recurrence rate was 45.3%in this group.Univariate logisticregression analysis showed that pN stage,pathological differentiation,lymph node ratio and perineural invasion were risk factors for postoperative recurrence in patients with stageⅢ-ⅣOSCC(P<0.05).Multivariate Logistic regression analysis showed that lymph node ratio and perineural invasion were independent risk factors for postoperative recurrence in patients with stageⅢ-ⅣOSCC[OR(95%CI):3.012(1.113-8.148),and 0.346(0.138-0.866),P<0.05].The overall survival rate(OSR)of patients with recurrence was significantly lower than that of patients without recurrence(3-year OSR 39.6%vs 92.8%,5-year OSR 21.9%vs 82.6%,P=0.000).Univariate survival analysis showed that pN stage and perineural invasion were the risk factors affecting the prognosis of recurrent patients(P<0.05).Multivariate survival analysis showed that pN stage and perineural invasion were independent risk factors for the prognosis of recurrent patients[HR(95%CI):1.229(0.996-1.517),and 0.490(0.266-0.901),P<0.05].Conclusion Patients with stageⅢ-ⅣOSCC have high recurrence rate and poor prognosis after recurrence.Lymph node ratio and perineural invasion are the undesirable characteristic affecting recurrence,while pN stage and perineural invasion are closely related to the prognosis of recurrent patients.
作者
张泽君
南欣荣
闫星泉
Zhang Zejun;Nan Xinrong;Yan Xingquan(School and Hospital of Stomatology,Shanxi Medical University,Shanxi 030001,China)
出处
《医学研究杂志》
2021年第2期102-106,共5页
Journal of Medical Research
基金
山西省重点研发计划项目(201803D31094)。
关键词
口腔鳞状细胞癌
复发
预后
淋巴结比率
神经侵犯
Oral squamous cell carcinoma
Recurrence
Prognosis
Lymph node ratio
Perineural invasion
