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背景与目的:cN0舌活动部鳞癌的治疗尚存在着争议。本研究的目的就是探讨影响cN0舌活动部鳞癌预后的因素并划分高危人群。方法:收集中山大学肿瘤防治中心1990年1月至1998年3月收治的cN0舌活动部鳞癌患者109例的临床资料,应用Cox多因素回归模型(Coxregressionmodel,Cox模型)分析预后影响因素并计算预后指数(prognosticindex,PI),依据个体化的PI,可将患者分为不同的危险组。结果:患者3年和5年的生存率分别为74.40%和69.31%。多因素分析结果显示cN0舌鳞癌患者的T分期、原发灶治疗方式、组织学分化、年龄和隐匿性颈淋巴转移对预后的影响有统计学意义(P<0.05),T分期是影响预后的最主要因素。原发灶综合治疗组优于单纯手术和单纯放疗或者化疗组;老年组、低分化组或者伴有隐匿性颈淋巴结转移组的患者预后较差。根据PI值将患者划分为高危组、中危组.cN0和低危组,3组的预后两两之间存在统计学差异(P<0.05),3组患者5年生存率分别是83.33%、64.12%和27.65%。结论:T分期、原发灶治疗方式、组织学分化、年龄和隐匿性颈淋巴结转移是影响cN0舌鳞癌预后的主要因素;PI值可用于预测cN0舌鳞癌患者的预后。
Background and Objective: The treatment of squamous cell carcinoma of the cN0 tongue is still controversial. The purpose of this study is to investigate the factors that affect the prognosis of squamous cell carcinoma of the cN0 tongue and to classify the at-risk population. Methods: The clinical data of 109 cases of squamous cell carcinoma of cN0 tongue active area treated in Cancer Center of Sun Yat-sen University from January 1990 to March 1998 were collected. Cox regression model (Cox regression model) was used to analyze the prognostic factors The prognostic index (PI), based on individualized PIs, classifies patients into different risk groups. Results: The 3-year and 5-year survival rates were 74.40% and 69.31% respectively. The results of multivariate analysis showed that T stage, primary tumor treatment, histological differentiation, age and occult cervical lymph node metastasis of cN0 tongue squamous cell carcinoma had a significant effect on prognosis (P <0.05), and T stage was the prognostic factor The most important factor. The primary tumor comprehensive treatment group was better than simple surgery and radiotherapy alone or chemotherapy group; the elderly group, poorly differentiated group or with occult cervical lymph node metastasis group patients with poor prognosis. According to the PI value, the patients were divided into high risk group, intermediate risk group, cN0 and low risk group, and the prognosis of each group was statistically significant (P <0.05). The 5-year survival rates of three groups were 83.33% 64.12% and 27.65% respectively. Conclusion: T stage, primary tumor treatment, histological differentiation, age and occult cervical lymph node metastasis are the main factors affecting the prognosis of cN0 tongue squamous cell carcinoma; PI value can be used to predict the prognosis of cN0 tongue squamous cell carcinoma patients.