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目的 探讨影响下咽癌颈淋巴结转移的临床病理因素和颈淋巴结转移对预后的影响。方法 采用 χ2 检验和Logistic回归分析 ,对 98例下咽癌患者的临床病理学因素与颈淋巴结转移的关系进行回顾性研究。并对颈淋巴结转移状态、转移颈淋巴结大小、转移颈淋巴结数目、转移颈淋巴结累及区域数、转移颈淋巴结最低受累区域等淋巴结病理学因素对生存率的影响 ,进行Cox回归分析。结果 下咽癌患者 5年生存率为 2 8 6 %。单因素和多因素分析均证实 ,肿瘤生长方式、肿瘤大小与发生颈淋巴结转移关系密切。而肿瘤突破基底膜达黏膜下层后对下咽癌颈淋巴结转移发生率不再产生进一步影响。Cox回归分析表明 ,临床N分期、颈淋巴结转移状态、转移颈淋巴结大小、转移颈淋巴结最低受累区域因素影响患者生存率 ,特别是转移颈淋巴结大小、转移颈淋巴结最低受累区域因素与下咽癌患者生存率明显相关。结论 下咽癌颈淋巴结转移是影响患者预后的重要因素 ,预测下咽癌颈淋巴结 ,对其作出早期正确诊断 ,并对影响预后的淋巴结因素采取相应治疗措施是提高下咽癌治疗效果的关键。
Objective To investigate the influence of clinicopathological factors and cervical lymph node metastasis on the prognosis of patients with hypopharyngeal carcinoma cervical lymph node metastasis. Methods Chi-square test and logistic regression analysis were used to analyze the relationship between clinicopathological factors and cervical lymph node metastasis in 98 patients with hypopharyngeal carcinoma. The Cox regression analysis was performed on the survival rate of cervical lymph node metastasis, the size of metastatic cervical lymph nodes, the number of metastatic cervical lymph nodes, the number of metastatic cervical lymph nodes and the lowest metastatic cervical lymph nodes. Results The 5-year survival rate of hypopharyngeal carcinoma patients was 286%. Univariate and multivariate analyzes confirmed that tumor growth pattern and tumor size were closely related to cervical lymph node metastasis. The tumor breakthrough basement membrane up to the submucosa on the incidence of cervical lymph node metastasis no longer have a further impact. Cox regression analysis showed that the survival rate of patients with clinical N staging, cervical lymph node metastasis, metastatic cervical lymph node size, metastatic lymph node minimum affected area factors affect the survival rate, especially the size of metastatic cervical lymph nodes, the lowest metastatic cervical lymph node involvement region and hypopharyngeal cancer patients Survival rate was significantly correlated. Conclusions The cervical lymph node metastasis of hypopharyngeal carcinoma is an important factor affecting the prognosis of patients with hypopharyngeal carcinoma. Predicting the cervical lymph nodes of hypopharyngeal carcinoma and making the correct early diagnosis, and taking the appropriate treatment measures for lymph node prognosis is the key to improve the therapeutic effect of hypopharyngeal carcinoma.