中国中部地区1 127例口腔癌预后影响因素分析
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摘要
目的:探索中国江西地区口腔癌预后的影响因素。方法:采用前瞻性临床随访设计,随访1 127例口腔癌患者,收集确诊病例的临床资料及随访生存情况,运用COX回归探讨口腔癌预后影响因素的风险比例(HR)及其95%可信区间(CI)。结果:对1 127例口腔癌患者共随访105 245. 06人月,通过寿命表法分析随访资料,结果显示该组口腔癌术后1、3、5、10年生存率分别为97%、75%、55%、34%,根据Kaplan-Meier得出所有患者平均中位生存时间为87. 186月,平均生存时间(89. 000±12. 764)月。单因素COX分析显示患者的年龄、受教育程度、职业、是否定期口腔检查、是否每日刷牙、是否有假牙、是否存在牙周炎等口腔疾患、T分期、N分期、浸润深度、是否血管神经受侵是口腔癌的预后影响因素(P <0. 05);患者的居住地、原发灶部位与口腔癌的预后无关(P> 0. 05);多因素COX分析显示患者年龄、T分期、N分期、浸润深度、是否存在血管/神经受侵是影响患者预后的独立因素(P <0. 05)。结论:患者年龄、T分期、N分期、浸润深度、是否存在血管/神经受侵是影响患者预后的独立因素。
Objective: To explore the influencing factors of oral cancer prognosis in Jiangxi,China. Methods: A prospective clinical follow-up design was used to follow 1 127 patients with oral cancer. The clinical data and follow-up survival of the confirmed cases were collected. The risk ratio( HR) and 95% confidence interval( CI) of prognostic factors in oral cancer were analyzed by COX regression. Results: A total of 1 127 patients with oral cancer were followed up for 105,245. 06 person-months. The follow-up data were analyzed by life table method. The results showed that the 1-,3-,5-,and 10-year survival rates of this group of oral cancer were 97%,75%,55%,and 34% respectively. According to Kaplan-Meier,the average median survival time of all patients was 87. 186 months,and the average survival time was( 89. 000 ± 12. 764) months. Univariate COX analysis showed the patient's age,education,occupation,regular oral examination,daily brushing,presence of dentures,presence of periodontitis and other oral conditions,T stage,N stage,depth of invasion,vascular nerves Invasion was the prognostic factor of oral cancer( P < 0. 05); the patient's place of residence and primary site were not associated with the prognosis of oral cancer( P > 0. 05); multivariate COX analysis showed patients' age,T stage,N stage,The depth of invasion and the presence of vascular/neural invasion were independent factors affecting the prognosis of patients( P < 0. 05). Conclusions: Patients' age,T stage,N stage,depth of invasion,and presence of vascular/neural invasion are independent factors that influence the prognosis of patients.
Objective: To explore the influencing factors of oral cancer prognosis in Jiangxi,China. Methods: A prospective clinical follow-up design was used to follow 1 127 patients with oral cancer. The clinical data and follow-up survival of the confirmed cases were collected. The risk ratio( HR) and 95% confidence interval( CI) of prognostic factors in oral cancer were analyzed by COX regression. Results: A total of 1 127 patients with oral cancer were followed up for 105,245. 06 person-months. The follow-up data were analyzed by life table method. The results showed that the 1-,3-,5-,and 10-year survival rates of this group of oral cancer were 97%,75%,55%,and 34% respectively. According to Kaplan-Meier,the average median survival time of all patients was 87. 186 months,and the average survival time was( 89. 000 ± 12. 764) months. Univariate COX analysis showed the patient's age,education,occupation,regular oral examination,daily brushing,presence of dentures,presence of periodontitis and other oral conditions,T stage,N stage,depth of invasion,vascular nerves Invasion was the prognostic factor of oral cancer( P < 0. 05); the patient's place of residence and primary site were not associated with the prognosis of oral cancer( P > 0. 05); multivariate COX analysis showed patients' age,T stage,N stage,The depth of invasion and the presence of vascular/neural invasion were independent factors affecting the prognosis of patients( P < 0. 05). Conclusions: Patients' age,T stage,N stage,depth of invasion,and presence of vascular/neural invasion are independent factors that influence the prognosis of patients.
引文
[1]Siegel RL,Miller KD,Jemal A.Cancer Statistics,2017[J].CA Cancer J Clin,2017,67(1):7-30.
[2]Kakuya T,Mori T,Yoshimoto S,et al.Prognostic significance of gene amplification of ACTN4 in stageⅠandⅡoral tongue cancer[J].Int J Oral Maxillofac Surg,2017,46(8):968-976.
[3]Geum DH,Roh YC,Yoon SY,et al.The impact factors on 5-year survival rate in patients operated with oral cancer[J].J Korean Assoc Oral Maxillofac Surg,2013,39(5):207-216.
[4]Bagan JV,Scully C.Recent advances in Oral Oncology2007:epidemiology,aetiopathogenesis,diagnosis and prognostication[J].Oral Oncol,2008,44(2):103-108.
[5]Siegel R,Naishadham D,Jemal A,et al.Cancer statistics[J].JAMA,2013,310(9):982.
[6]卞金有,胡德渝.预防口腔医学[M].北京:人民卫生出版社,2003:2031-2032.
[7]Chaturvedi AK,Anderson WF,Lortet-Tieulent J,et al.Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers[J].Journal of clinical oncology:official journal of the American Society of Clinical Oncology,2013,31(36):4550-4559.
[8]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[9]Conway DI,Petticrew M,Marlborough H,et al.Socioeconomic inequalities and oral cancer risk:a systematic review and meta-analysis of case-control studies[J].Int JCancer,2008,122(12):2811-2819.
[10]Warnakulasuriya S.Significant oral cancer risk associated with low socioeconomic status[J].Evid Based Dent,2009,10(1):4-5.
[11]Giraldi L,Leoncini E,Pastorino R,et al.Alcohol and cigarette consumption predict mortality in patients with head and neck cancer:a pooled analysis within the International Head and Neck Cancer Epidemiology(IN-HANCE)Consortium[J].Ann Oncol,2017,28(11):2843-2851.
[12]Nagao T,Ikeda N,Warnakulasuriya S,et al.Serum antioxidant micronutrients and the risk of oral leukoplakia among Japanese[J].Oral Oncol,2000,36(5):466-470.
[13]Brown JS,Bekiroglu F,Shaw RJ,et al.Management of the neck and regional recurrence in squamous cell carcinoma of the maxillary alveolus and hard palate compared with other sites in the oral cavity[J].Head Neck,2013,35(2):265-269.
[14]Yuen AP,Lam KY,Wei WI,et al.A comparison of the prognostic significance of tumor diameter,length,width,thickness,area,volume,and clinicopathological features of oral tongue carcinoma[J].Am J Surg,2000,180(2):139-143.
[15]Fukano H,Matsuura H,Hasegawa Y,et al.Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma[J].Head Neck,1997,19(3):205-210.
[16]Wu K,Yang X,Li L,et al.Neurovascular Invasion and Histological Grade Serve as the Risk Factors of Cervical Lymph Node Metastases in Early Tongue Squamous Cell Carcinoma[J].Mol Neurobiol,2016,53(5):2920-2926.
[17]Woolgar JA.Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma[J].Oral Oncol,2006,42(3):229-239.
[2]Kakuya T,Mori T,Yoshimoto S,et al.Prognostic significance of gene amplification of ACTN4 in stageⅠandⅡoral tongue cancer[J].Int J Oral Maxillofac Surg,2017,46(8):968-976.
[3]Geum DH,Roh YC,Yoon SY,et al.The impact factors on 5-year survival rate in patients operated with oral cancer[J].J Korean Assoc Oral Maxillofac Surg,2013,39(5):207-216.
[4]Bagan JV,Scully C.Recent advances in Oral Oncology2007:epidemiology,aetiopathogenesis,diagnosis and prognostication[J].Oral Oncol,2008,44(2):103-108.
[5]Siegel R,Naishadham D,Jemal A,et al.Cancer statistics[J].JAMA,2013,310(9):982.
[6]卞金有,胡德渝.预防口腔医学[M].北京:人民卫生出版社,2003:2031-2032.
[7]Chaturvedi AK,Anderson WF,Lortet-Tieulent J,et al.Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers[J].Journal of clinical oncology:official journal of the American Society of Clinical Oncology,2013,31(36):4550-4559.
[8]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[9]Conway DI,Petticrew M,Marlborough H,et al.Socioeconomic inequalities and oral cancer risk:a systematic review and meta-analysis of case-control studies[J].Int JCancer,2008,122(12):2811-2819.
[10]Warnakulasuriya S.Significant oral cancer risk associated with low socioeconomic status[J].Evid Based Dent,2009,10(1):4-5.
[11]Giraldi L,Leoncini E,Pastorino R,et al.Alcohol and cigarette consumption predict mortality in patients with head and neck cancer:a pooled analysis within the International Head and Neck Cancer Epidemiology(IN-HANCE)Consortium[J].Ann Oncol,2017,28(11):2843-2851.
[12]Nagao T,Ikeda N,Warnakulasuriya S,et al.Serum antioxidant micronutrients and the risk of oral leukoplakia among Japanese[J].Oral Oncol,2000,36(5):466-470.
[13]Brown JS,Bekiroglu F,Shaw RJ,et al.Management of the neck and regional recurrence in squamous cell carcinoma of the maxillary alveolus and hard palate compared with other sites in the oral cavity[J].Head Neck,2013,35(2):265-269.
[14]Yuen AP,Lam KY,Wei WI,et al.A comparison of the prognostic significance of tumor diameter,length,width,thickness,area,volume,and clinicopathological features of oral tongue carcinoma[J].Am J Surg,2000,180(2):139-143.
[15]Fukano H,Matsuura H,Hasegawa Y,et al.Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma[J].Head Neck,1997,19(3):205-210.
[16]Wu K,Yang X,Li L,et al.Neurovascular Invasion and Histological Grade Serve as the Risk Factors of Cervical Lymph Node Metastases in Early Tongue Squamous Cell Carcinoma[J].Mol Neurobiol,2016,53(5):2920-2926.
[17]Woolgar JA.Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma[J].Oral Oncol,2006,42(3):229-239.