咀嚼槟榔与口腔鳞癌的相关临床病理学因素分析

目的: 探讨咀嚼槟榔与口腔鳞癌(oral squamous cell carcinoma,OSCC)相关临床病理学因素及免疫表型的关系。方法: 收集88例OSCC患者资料,根据是否有咀嚼槟榔习惯,分别进行临床病理因素及相关免疫组织化学分析。通过单因素和多因素回归分析,寻找咀嚼槟榔与口腔鳞癌相关的临床病理学因素。采用SPSS 17.0软件包对数据进行统计学分析。结果: 46.6%的OSCC患者有咀嚼槟榔习惯,病变以舌和颊为主,占67.0%,pT分期以T2期为主,占40.9%。在单因素分析中,肿瘤分化程度,ki-67和p53蛋白阳性表达率与咀嚼槟榔习惯显著相关(P<0.05),而性别、年龄、发生部位、pT分期、颈淋巴结转移与咀嚼槟榔习惯无显著相关性(P>0.05);在多因素分析中,肿瘤发生部位和分化程度与咀嚼槟榔习惯有显著相关性(P<0.05)。结论: ki-67和p53蛋白在有咀嚼槟榔习惯组中低表达,预示肿瘤细胞增殖活跃程度、恶性程度、分化程度、预后等临床病理学因素相对良好;有咀嚼槟榔习惯的OSCC患者,肿瘤分化程度相对良好,颊部和舌部是口腔鳞癌的好发部位。

Correlation of betel nut chewing and clinicopathologic factors of oral squamous cell carcinoma

PURPOSE: To investigate the correlation of clinicopathologic factors and immunophenotypic features with betel nut chewing in oral squamous cell carcinoma(OSCC). METHODS: The data of 88 patients with OSCC were collected. According to the habit of betel nut chewing, the clinicopathologic factors and immunohistochemical parameters were analyzed. The relationship between clinicopathologic factors of OSCC and betel nut chewing was analyzed with univariate analysis and multivariate analysis using SPSS 17.0 software package. RESULTS: 46.6% of patients had the habit of betel nut chewing and 67.0% of patients had tongue cancer and buccal cancer. The pathological stages were mainly T2 (40.9%). From univariate analysis of the results, differentiation degree, ki-67, p53 was significantly correlated with the habit of betel nut chewing(P<0.05); while gender, age, location, pathological T stage and cervical lymph node metastasis were not significantly correlated with habit of betel nut chewing (P>0.05). From multivariate analysis of the results, location and differentiation degree were significantly correlated with the habit of betel nut chewing (P<0.05). CONCLUSIONS: ki-67 and p53 protein are lowly expressed in OSCC patients with the habit of betel nut chewing, suggesting that clinicopathologic factors such as the proliferation activity, malignancy, differentiation and prognosis of tumor are much better. Differentiation degree are relatively good in OSCC patients with the habit of betel nut chewing. Cheek and tongue are the most common site of OSCC.