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目的探讨影响新疆132例舌体鳞状细胞癌(TSCC)患者预后的因素。方法病例为新疆医科大学第一附属医院2003年1月至2011年12月经病理确诊且随访资料完整的132例初治TSCC患者,其中24例未手术,108例手术(94例行颈部淋巴结清扫);根据治疗方式分为单纯手术治疗29例,单纯放疗10例及综合治疗93例。随访患者生存情况并采用Kaplan-Meier法进行生存分析,分析不同临床病理参数(性别、民族、年龄、分化程度、T分期、N分期、TNM分期、侵犯舌根、侵犯中线、侵犯口底及局部复发)及治疗方式(原发灶手术、放疗、化疗、颈部淋巴结清扫及手术情况)的5年生存率,同时采用Cox回归模型分析影响预后的独立因素。结果 132例患者共随访5~120个月,9例失访,随访率为93.2%。61例生存,死亡62例,其中58例死于肿瘤相关疾病。132例患者的中位生存期为80.0个月,5年生存率为59.8%。临床病理参数中不同分化程度、T分期、N分期、TNM分期、是否侵犯中线、侵犯口底和局部复发及不同治疗方式中的是否为原发灶手术、放疗、颈部淋巴结清扫和手术情况的5年生存率差异有统计学意义(P<0.05)。多因素分析显示,分化程度、局部复发、原发灶手术、TNM分期和放疗是影响TSCC预后的独立因素。结论原发灶彻底手术、合理颈部淋巴结清扫及预防局部复发能够改善TSCC患者的预后。早期TSCC建议首选手术治疗,而中晚期首选以手术为主的综合治疗,术后放疗的疗效较好。
Objective To explore the factors influencing the prognosis of 132 cases of tongue squamous cell carcinoma (TSCC) in Xinjiang. Methods The cases were 132 newly diagnosed TSCC patients who were confirmed by pathology and were followed up from January 2003 to December 2011 in the First Affiliated Hospital of Xinjiang Medical University. Among them, 24 cases were operated without surgery and 108 cases were operated with 94 cases of neck lymph node dissection ); According to the treatment is divided into simple surgery in 29 cases, simple radiotherapy in 10 cases and 93 cases of comprehensive treatment. Survival of patients was followed up and Kaplan-Meier method was used for survival analysis. The clinical and pathological parameters including sex, ethnicity, age, differentiation, T stage, N stage, TNM stage, tongue base invasion, midline invasion, mouth and local recurrence were analyzed. ) And the 5-year survival rate of the treatment (primary surgery, radiotherapy, chemotherapy, cervical lymph node dissection and operation), and Cox regression model was used to analyze the independent factors influencing the prognosis. Results A total of 132 patients were followed up for 5 to 120 months. Nine patients were lost to follow-up. The follow-up rate was 93.2%. Sixty-one survived and died of 62 cases, of which 58 died of tumor-related diseases. The median survival of 132 patients was 80.0 months, and the 5-year survival rate was 59.8%. Clinicopathological parameters of different degrees of differentiation, T staging, N staging, TNM staging, whether invade the midline, invasion of mouth and local recurrence and different treatment is primary surgery, radiotherapy, cervical lymph node dissection and surgery The 5-year survival rate was significantly different (P <0.05). Multivariate analysis showed that the degree of differentiation, local recurrence, primary tumor surgery, TNM staging and radiotherapy were independent prognostic factors of TSCC. Conclusions Thorough surgery of primary tumor, rational neck lymph node dissection and prevention of local recurrence can improve the prognosis of patients with TSCC. Early TSCC recommended surgical treatment, and the preferred mid-late surgery-based comprehensive treatment, postoperative radiotherapy is better.