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目的:探讨影响舌体鳞状细胞癌患者复发的临床病理因素。方法:选择2003-01-01-2011-12-31在新疆医科大学第一附属医院首治的经病理确诊,且随访资料完整的舌体鳞癌患者共136例。Kaplan-Meier计算累积生存率,组间差异采用Log-rank检验。Cox回归模型行多因素分析,确立影响复发的独立因素。结果:136例患者总复发率为52.94%(72/136),平均复发时间为34.05个月,中位复发时间为65个月。单因素分析结果显示,影响复发的因素为民族、病理分级、T分期、N分期、TNM分期、侵犯中线、侵犯口底、原发灶手术和是否行颈淋巴结清除术。多因素分析结果显示,影响复发的独立因素为T分期、N分期和是否行颈淋巴结清除术。隐匿性淋巴结转移率为14.89%(14/94),其中T1和T2发生隐匿性淋巴结转移率为15.19%(12/79),T3和T4发生隐匿性淋巴结转移率为13.33%(2/15),转移区域分布于Ⅰ~Ⅳ区,未见Ⅴ区转移。舌体鳞癌患者选择以手术为主的综合治疗可以降低复发率。结论:影响复发的独立危险因素为T分期、N分期和是否行淋巴结清除术。
Objective: To explore the clinicopathological factors affecting the recurrence of tongue squamous cell carcinoma. Methods: A total of 136 patients with tongue squamous cell carcinoma diagnosed by pathology and having complete follow-up data from January 2003 to January 2011 were enrolled in the First Affiliated Hospital of Xinjiang Medical University. Kaplan-Meier calculated cumulative survival rate, the difference between groups using Log-rank test. Cox regression model of multi-factor analysis to establish the independent factors that affect the recurrence. Results: The total recurrence rate of 136 patients was 52.94% (72/136), the average recurrence time was 34.05 months and the median recurrence time was 65 months. Univariate analysis showed that the factors influencing recurrence were ethnicity, histological grade, T stage, N stage, TNM stage, center line of infringement, invasion of floor of mouth, primary tumor and neck dissection. Multivariate analysis showed that independent factors affecting the recurrence of T staging, N staging and whether cervical lymph node dissection. The occult lymph node metastasis rate was 14.89% (14/94). The occult lymph node metastasis rate was 15.19% (12/79) in T1 and T2, and the occult lymph node metastasis rate in T3 and T4 was 13.33% (2/15) , The transfer area is located in Ⅰ ~ Ⅳ area, no Ⅴ area transfer. Squamous cell carcinoma of the tongue in patients with surgery-based comprehensive treatment can reduce the recurrence rate. Conclusion: The independent risk factors of recurrence were T stage, N stage and lymph node dissection.