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目的:总结声门上型喉癌的临床特征,分析其预后的影响因素。方法:声门上型喉鳞癌94例。Kaplan-meier曲线行生存分析,Cox回归模型行多因素分析。结果:声门上型喉癌首发症状以声嘶最常见(47例,50.0%),其他依次为咽部不适(30例,31.9%)、颈部肿物(15例,16.0%),呼吸困难(2例,0.2%)。初诊时淋巴结转移发生率高(36例,38.3%),患者多处于疾病晚期(Ⅲ、Ⅳ期76例,80.9%)。原发灶根治性治疗主要采取声门上水平喉半切除术或喉全切除术(58例,61.7%),余患者采取姑息性气管切开术,或姑息化疗、放疗。声门上型喉癌的总体5年生存率为41.55%。Cox回归多因素分析显示,影响声门上型喉癌预后的独立因素为T分期(W=7.308,P=0.006)、是否手术(W=26.538,P=0.000)。结论:声门上型喉癌早期诊断率较低,疾病进展快,预后差。早期发现并控制原发灶对改善声门上型预后存在重要意义。
Objective: To summarize the clinical characteristics of supraglottic laryngeal cancer and analyze the influencing factors of prognosis. Methods: 94 cases of supraglottic laryngeal squamous cell carcinoma. Survival analysis of Kaplan-Meier curve and multivariate analysis of Cox regression model. Results: The most common symptoms of supraglottic laryngeal cancer were hoarseness (47 cases, 50.0%), followed by throat discomfort (30 cases, 31.9%), neck mass (15 cases, 16.0%), Difficulty (2 cases, 0.2%). The incidence of lymph node metastasis at the time of first visit was high (36 cases, 38.3%). Most of the patients were in the advanced stage of disease (76 in stage Ⅲ and Ⅳ, 80.9%). Radical main treatment of radical glottic laryngectomy or laryngectomy (58 cases, 61.7%), the remaining patients to take palliative tracheostomy, or palliative chemotherapy, radiotherapy. The overall 5-year survival rate of supraglottic laryngeal cancer was 41.55%. Cox regression multivariate analysis showed that independent factors affecting the prognosis of supraglottic laryngeal cancer were T stage (W = 7.308, P = 0.006) and surgery (W = 26.538, P = 0.000). Conclusion: The diagnosis of supraglottic laryngeal carcinoma is of low early diagnosis, rapid disease progression and poor prognosis. Early detection and control of primary lesions have important implications for improving supraglottic outcome.