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目的 探讨影响鼻腔腺样囊性癌患者预后的因素。方法 原发于鼻腔的腺样囊性癌38例 ,对其治疗与预后进行统计分析。生存分析采用Kaplan Meier法 ,组间比较采用Logrank检验 ,多因素分析采用Cox比例风险模型。结果 临床治疗结束时肿瘤完全消失者 5、10年生存率分别为10 0 %和 88.9% ,临床治疗结束时残留者 5、10年生存率分别为 4 8.0 %和 0 % (P <0 .0 1)。早期 (Ⅰ、Ⅱ期 )患者 5、10年生存率分别为 86 .7%和 75 .8% ,晚期 (Ⅲ、Ⅳ期 )患者分别为 5 8. 6 %和 0 % (P <0 .0 1)。单纯手术者 5、10年生存率分别为 5 1.4 %和 2 5 .7% ,单纯放射治疗者均为 5 0 .0 % ,综合治疗者分别为 84 .4 %和 6 2 .0 % (P >0 .0 5 )。多因素分析表明临床治疗近期疗效、临床分期是影响预后的独立因素。结论 鼻腔腺样囊性癌的治疗以综合治疗为主 ,临床治疗近期疗效、临床分期和临床治疗方法对预后有重要影响。
Objective To explore the factors affecting the prognosis of patients with nasal adenoid cystic carcinoma. Methods Thirty-eight cases of adenoid cystic carcinoma in the nasal cavity were included in the study. The treatment and prognosis were analyzed statistically. Kaplan Meier method was used for survival analysis, Logrank test was used for comparison among groups, and Cox proportional hazards model was used for multivariate analysis. Results The 5-year and 10-year survival rates were 100% and 88.9% respectively at the end of clinical treatment. The 5-year and 10-year survival rates at the end of clinical treatment were 40.0% and 0% (P0.01) 1). The 5-year and 10-year survival rates were 86.7% and 75.8% in patients with advanced stage Ⅰ and stage Ⅱ, respectively, and were 8.6% and 0% in patients with advanced stage Ⅲ and Ⅳ (P0.01 1). The 5-year and 10-year survival rates were 51.4% and 25.7% in the simple surgeries, 50.0% in the radiotherapy alone groups, 84.4% and 62.0% in the combined treatment group respectively > 0 .0 5). Multivariate analysis showed that the short-term efficacy of clinical treatment, clinical stage is an independent prognostic factor. Conclusions The treatment of nasal adenoid cystic carcinoma is mainly comprehensive treatment. The short-term effect, clinical stage and clinical treatment of clinical treatment have a significant impact on prognosis.