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目的探讨CT1-2N0舌鳞癌复发的主要相关因素及各因素对生存率的影响,为临床治疗提供进一步的指导方案。方法回顾性分析天津医科大学附属肿瘤医院1992年1月~2004年12月收治的161例CT1-2N0期舌鳞癌患者的临床资料(T1 83例和T2 78例),Kaplan-Meier法对各因素进行生存率分析并计算生存率,log-rank法比较各因素不同水平生存分布的差异。检验和Cox模型,χ2检验分析性别,年龄,肿瘤TNM分期,病理分级,治疗方案与复发及预后的关系。结果 T1与T2期两组复发率分别为22.2%,35%,二者差异有统计学意义(P<0.05);高分化鳞癌与中低分化鳞癌组的复发率分别为21.4%,47.7%,二者差异有统计学意义(P<0.01);综合治疗组与单纯手术组的复发率分别为18.3%,34.7%,差异有统计学意义(P<0.05);行颈清扫组与未行颈清扫组的复发率分别为24.6%,42.9%(P<0.05)。复发组及非复发组3年及5年生存率分别为43.5%,95.7%及19.6%,90.4%,差异有统计学意义(P<0.01)。≥45岁组及<45岁组3年及5年生存率分别为85.2%,82.0%及78.0%,63.0%(P<0.05)。结论临床分期,病理分级,是否行颈清扫及是否综合治疗是影响早期舌癌复发的原因,患者年龄及是否复发是影响早期舌癌预后的因素,并且是影响预后的独立因素。
Objective To investigate the main related factors of CT1-2N0 tongue squamous cell carcinoma recurrence and the influence of various factors on the survival rate and to provide further guidance for clinical treatment. Methods The clinical data of 161 patients with CT1-2N0 tongue squamous cell carcinoma (T1 83 and T2 78) admitted to Tumor Hospital Affiliated to Tianjin Medical University from January 1992 to December 2004 were retrospectively analyzed. Kaplan-Meier methods Factors of survival rate analysis and calculate the survival rate, log-rank method to compare the various factors of different levels of survival distribution differences. Test and Cox model, χ2 test analysis of gender, age, tumor TNM staging, pathological grading, treatment regimens and relapse and prognosis. Results The recurrence rates of the two groups were 22.2% and 35%, respectively (P <0.05). The recurrence rates in well-differentiated and moderately-differentiated squamous cell carcinomas were 21.4% and 47.7%, respectively %, Respectively. The difference between the two groups was statistically significant (P <0.01). The recurrence rates were 18.3% and 34.7% in the comprehensive treatment group and the simple operation group respectively, with significant difference (P <0.05) The recurrence rates of neck dissection group were 24.6% and 42.9% (P <0.05). The 3-year and 5-year survival rates of relapsed and non-relapsed patients were 43.5%, 95.7% and 19.6%, 90.4%, respectively, with significant difference (P <0.01). The 3-year and 5-year survival rates of patients aged 45 and 45 years were 85.2%, 82.0% and 78.0%, 63.0%, respectively (P <0.05). Conclusions Clinical staging, pathological grade, whether neck dissection and comprehensive treatment are the causes of early tongue cancer recurrence. Whether the patient’s age and recurrence are prognostic factors of early tongue cancer is an independent factor influencing prognosis.