口腔舌癌与口底癌患者预后的比较研究

【摘要】目的 比较口腔舌癌患者与口底癌患者的预后，并分析影响预后的因素。方法 收集首次治疗的口腔癌患者病历资料，据肿瘤所在部位分为口腔舌癌组（舌癌组）与口底癌组，按性别、年龄、T分期与肿瘤分化程度等因素匹配，最终确定舌癌组100例和口底癌组50例。Kaplan-Meier分析比较2组总生存率(OS)与疾病特异性生存率(DSS)，对2组基本特征行单因素分析，采用Cox回归模型分析影响患者预后的因素。结果 3年和5年总OS分别为舌癌组65%、51%；口底癌组40%、28%。3年和5年DSS分别为舌癌组61%、46%；口底癌组38%、26%。2组间OS与DSS差异均有统计学意义（P＜0.05或P＜0.01）。多因素分析显示复发（RR=1.431，P=0.019）与局部淋巴结转移（RR=1.526，P=0.043）为影响舌癌与口底癌患者预后的危险因素。结论 舌癌组的预后优于口底癌组。两者预后与复发和局部淋巴结转移密切相关。根据肿瘤部位不同采用个体化治疗方式有助于改善舌癌患者的整体预后。

The Comparative Study of Prognosis in Patients with Oral Tongue Cancer and Base of Tongue Cancer

[Abstract] Objective To compare the prognosis of patients with oral tongue cancer and the base of tongue cancer,and identify the prognostic factors. Methods The patient records that were first accepted clinical treatments were collected.Patients were divided into oral tongue cancer group and the base of tongue cancer group, according to the tumor location. One hundred oral tongue cancer cases that were matched with fifty base of tongue cancer cases for gender, age, T-stage and tumor differentiation were simultaneously enrolled in the study. The survival rate and disease-specific survival rate were analyzed by Kaplan-Meier analysis. The multivariate analysis was conducted with the Cox regression model in two groups.Results The three-year and five-year survival rates were 65% and 51% in oral tongue cancer group, and 40% and 28% in base of tongue cancer group. The three-year and five-year disease-specific survival rates were 61% and 46% in oral tongue cancer group, and 38% and 26% in base of tongue cancer group. There were significant differences in three-year and five-year survival rates and disease-specific survival rates between two groups (P＜0.05 or P＜0.01). Multivariate analysis showed that the recurrence (RR=1.431，P=0.019) and regional lymph node metastasis (RR=1.526，P=0.043) were prognostic risk factors.Conclusion There was a better prognosis in tongue cancer group than that of the base of tongue cancer group. In the present study, the difference in prognosis was closely associated with the recurrence and regional lymph node metastasis in two groups. We concluded that the individual treatment should be used for patients with tongue cancer to improve prognosis.