影响舌鳞状细胞癌患者预后的临床病理因素分析

目的：研究影响舌鳞状细胞癌患者预后的临床病理因素，方法：应用临床病理指标分析舌鳞状细胞癌患者预后的相关因素。结果：肿瘤分化程度，淋巴细胞浸润程度与区域淋巴结转移无关；肿瘤大小与区域淋巴结转移有关，肿瘤大小，淋巴细胞浸润程度与术后发生转移无关，分化程度与术后复发转移有关，结论：对于肿瘤直径大的舌鳞状细胞癌应积极采取病灶切除及颈淋巴结清扫术，肿瘤分化程度低者术后易出现复发转移。     

143例舌体鳞状细胞癌年轻患者的预后因素

目的探讨舌体鳞癌年轻患者的预后及其影响因素。方法回顾性分析143例45岁以下舌体鳞癌患者的临床资料,采用Kaplan-Meier法计算累积生存率,采用log-rank法比较各因素不同水平生存分布的差异,应用Cox比例风险模型进行多因素生存分析。结果全组5年累积生存率为62.2%,10年累积生存率为60.5%。单因素分析显示：有无浸润肌层、不同病理分级、T分级、N分级、TMN分期、原发灶有无行根治性手术治疗、有无颈部淋巴结清扫术的生存差异有统计学意义。多因素分析显示：T分级、N分级是影响预后的独立因素。结论T分级和N分级是45岁以下舌体鳞癌患者的独立预后因素,原发灶手术治疗、颈部淋巴结清扫彻底以及合理的综合治疗,可能改善舌体鳞癌年轻患者的预后。     

肺鳞状细胞癌预后相关影响因素研究进展

肺鳞状细胞癌在肺癌中所占比例为20%~30%,每年在全世界造成约40万人死亡。肺鳞状细胞癌患者的预后较差,这是因为患者确诊时常常已经发展到了晚期。影响肺鳞状细胞癌预后的因素有很多,例如性别和吸烟。本研究就自身因素(吸烟情况、性别、年龄、BMI、并发症)、肿瘤因素(亚部位、转移情况)和治疗因素对肺鳞状细胞癌预后的影响做一综述。     

新疆132例舌体鳞状细胞癌的预后分析

目的 探讨影响新疆132例舌体鳞状细胞癌（TSCC）患者预后的因素。方法 病例为新疆医科大学第一附属医院2003年1月至2011年12月经病理确诊且随访资料完整的132例初治TSCC患者,其中24例未手术,108例手术（94例行颈部淋巴结清扫）;根据治疗方式分为单纯手术治疗29例,单纯放疗10例及综合治疗93例。随访患者生存情况并采用Kaplan-Meier 法进行生存分析,分析不同临床病理参数（性别、民族、年龄、分化程度、T分期、N分期、TNM分期、侵犯舌根、侵犯中线、侵犯口底及局部复发）及治疗方式（原发灶手术、放疗、化疗、颈部淋巴结清扫及手术情况）的5年生存率,同时采用Cox回归模型分析影响预后的独立因素。结果 132例患者共随访5～120个月,9例失访,随访率为93.2％。61例生存,死亡62例,其中58例死于肿瘤相关疾病。132例患者的中位生存期为80.0个月,5年生存率为59.8％。临床病理参数中不同分化程度、T分期、N分期、TNM分期、是否侵犯中线、侵犯口底和局部复发及不同治疗方式中的是否为原发灶手术、放疗、颈部淋巴结清扫和手术情况的5年生存率差异有统计学意义（P＜0.05）。多因素分析显示,分化程度、局部复发、原发灶手术、TNM分期和放疗是影响TSCC预后的独立因素。结论 原发灶彻底手术、合理颈部淋巴结清扫及预防局部复发能够改善TSCC患者的预后。早期TSCC建议首选手术治疗,而中晚期首选以手术为主的综合治疗,术后放疗的疗效较好。     

口腔舌鳞状细胞癌的临床分析

目的:总结口腔舌鳞状细胞癌的治疗经验以指导临床。方法:回顾性分析1975年1月～2000年12月初次在我院诊治的329例口腔舌鳞状细胞癌患者的临床资料。T1病变82例,T2病变190例,T3病变43例,T4病变14例。综合治疗186例,单纯手术84例,单纯放疗59例。结果:91例患者组织学检查颈部淋巴结转移,其中Ⅰ区淋巴结转移36例,Ⅱ区淋巴结转移65例,Ⅲ区淋巴结转移18例,Ⅳ区淋巴结转移10例。T1病变患者5年和10年累积生存率分别为72.23%和65.21%,T2分别为38.38%和33.11%,T3分别为10.63%和10.63%,T4分别为7.14%和7.14%(P=0.0000,Logrank=75.99)。单纯手术组患者5年和10年累积生存率分别为56.13%和47.28%,单纯放疗组分别为17.49%和17.49%,综合治疗组分别为43.51%和39.04%(P=0.0000,Logrank=42.23)。结论:口腔舌鳞状细胞癌早期病变可考虑单纯手术,而中晚期应给予综合治疗,对中晚期cN0患者可考虑扩大的肩胛舌骨肌上清扫术。     

舌鳞状细胞癌预后多因素分析

目的探讨影响舌鳞状细胞癌预后的相关临床等因素。方法回顾性分析175例舌鳞状细胞癌的长期随访资料,采用SPSS 13.0统计软件进行分析。频数资料组间比较采用χ2检验。临床病理指标单因素分析采用Kaplan-Meier法,组间曲线比较用Log-Rank检验,多因素分析采用Cox回归分析。结果全组患者3、5年生存率分别为76.5%、65.4%。单因素分析显示,肿瘤大小、肿瘤是否越过中线、舌外是否侵犯、组织学分级、临床分期、淋巴结转移、局部复发、治疗方式是影响预后的重要因素(P<0.05);多因素分析显示,临床分期、组织学分级、局部复发是影响舌鳞状细胞癌预后的重要因素(P<0.05)。结论影响舌鳞状细胞癌预后的主要因素是临床分期、组织学分级、局部复发。     

外阴鳞状细胞癌术后复发的影响因素

外阴鳞状细胞癌（vulvar squamous cell carcinoma,VSCC）是一种罕见的妇科恶性肿瘤,近年来其发病率和死亡率逐年升高,术后高复发率是VSCC患者死亡的重要原因。本文从国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）分期相关因素、手术及术后病理、辅助治疗三个角度对与VSCC术后复发风险相关的因素进行综述,以期通过综合控制各种影响因素,降低术后复发风险,改善VSCC患者的预后。     

早期舌鳞状细胞癌的疗效分析

目的 分析不同方法治疗Ⅰ、Ⅱ期舌鳞癌的疗效.方法 回顾性分析103例Ⅰ、Ⅱ期舌鳞癌患者,比较单纯手术、单纯放疗和综合治疗(术前或术后放疗)的疗效及其影响因素.结果Ⅰ、Ⅱ期患者的5年生存率分别为82.4%和80.O%(P=0.361),其中单纯手术组、单纯放疗组和综合治疗组的5年生存率分别为90.3%、68.4%和84.0%(P=0.104),局部复发率分别为2.5%、35.7%和5.7%(P＜0.001).隐匿性淋巴结转移率为23.8%,其中Ⅱ区的转移率(19.0%)最高.局部复发、区域复发是影响患者预后的独立因素,单纯手术即能获得满意的局部控制,而低分化鳞癌易出现区域复发.结论 选用单纯手术治疗早期舌癌,如采用择区性颈淋巴清扫术,清扫范围为Ⅰ～Ⅳ区.     

早期舌鳞癌复发原因及预后因素的分析

背景与目的：早期舌癌的治疗效果理想,但复发是影响早期舌癌治疗效果的重要因素。本研究回顾性分析227例早期舌癌的临床资料,探讨早期舌癌复发的主要原因及影响预后的因素。方法：收集中山大学肿瘤防治中心1992—2003年首治的227例早期舌鳞癌患者的临床资料,Kaplan—Meier法对各影响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。Cox同归模型进行多因素分析,影响复发不同因素间比较用卡方检验。结果：高分化鳞癌组复发率为19.3％,中高低分化鳞癌组复发率为39．2％,二者的差异具有统计学意义（P=0．004）,综合治疗组复发率为15％,单纯手术组复发率为28％．二者的差异具有统计学意义（P=0．014）。复发组及非复发组3年及5年生存率分别为40．7％、87.3％及25．9％、80．3％,二者的差异具有统计学意义（P=0.000）。行颈清扫组及未行颈清扫组3年及5年生存率分别为为76．4％、75．0％及68％、61．2％．二者的差异具有统计学意义（P=0．023）;≥45岁组及〈45岁组3年及5年生存率分别为75．6％、78％及59．5％、66．1％,二者的差异具有统计学意义（p=0．021）。结论：病理分级及是否进行综合治疗是影响早期舌癌复发的原因,患者的年龄、是否行颈清扫、是否复发是影响早期舌癌预后的因素,年龄及是否复发是影响预后的独立因素。     

神经周围浸润与早期舌鳞状细胞癌患者临床病理特征的相关性及对预后的影响

目的:探讨神经周围浸润（perineural invasion,PNI）与早期舌鳞状细胞癌（tongue squamous cell carcinoma,TSCC）患者临床病理特征的相关性及对预后的影响。方法:收集75例早期TSCC患者的完整病例资料,观察PNI情况并分析其与TSCC临床病理特征的关系及对患者5年生存率和生存期的影响。结果:PNI阳性与性别、年龄、临床分期差异均无统计学意义（P＞0.05）;PNI阳性与分化程度、淋巴结转移、浸润深度、淋巴脉管浸润、手术切缘阳性差异均有统计学意义（P＜0.05）。PNI阳性患者5年生存率及生存期均明显低于PNI阴性者（P＜0.05）。COX多因素回归分析表明PNI阳性是早期TSCC患者术后预后的独立危险因素（P＜0.05）。结论:PNI阳性对早期TSCC患者的预后有影响,对早期TSCC患者预后辅助治疗的方案设计具有一定的参考价值,并且可以作为早期TSCC患者预后判断的独立危险因素。     

Metabolic syndrome is associated with better prognosis in patients with tongue squamous cell carcinoma

Introduction:Metabolic syndrome (MS) is associated with several cancers, but it is not clear whether MS affects the prognosis of tongue squamous cell carcinoma (TSCC). This study aimed to evaluate the ...     

Poor prognosis in patients with stage I and II oral tongue squamous cell carcinoma

BACKGROUND: The objective of this study was to compare survival in patients with squamous cell carcinoma (SCC) of the oral tongue with that in patients with SCC in other oral cavity subsites. METHODS: Patients with stage I and II (T1-T2N0M0) SCC of the oral cavity diagnosed between 1988 and 2004 were queried by using the Surveillance, Epidemiology, and End Results (SEER) database. The log-rank test was used to compare the overall survival (OS) and cause-specific survival (CSS) of patients who had oral tongue SCC with those of patients who had SCC of other oral cavity subsites. A Cox proportional hazards multivariate analysis was performed to evaluate the influence of covariates on the risk of CSS and OS. RESULTS: Between 1988 and 2004, 6791 patients with stage I and II SCC of the oral cavity were identified. Among them, 40% had oral tongue SCC, and 60% had SCC of other oral cavity subsites. The median patient age was 64 years. The 5-year OS and CSS rates were 60.9% and 83.5%, respectively, for patients with oral tongue SCC versus 64.7% and 94.1%, respectively, for patients with SCC of other oral cavity subsites (OS: hazard ratio, 1.24; P< .0001; CSS: hazard ratio, 3.04; P< .0001). On multivariate analysis, OS and CSS were influenced significantly by T classification, age, sex, and oral tongue subsite. The CSS for patients who had stage I and II oral tongue SCC also was unfavorable compared with the CSS for stage-matched patients who had SCC of other head and neck sites. CONCLUSIONS: Oral tongue SCC was associated with poor survival compared with other oral cavity and head and neck sites. These data suggested a potential benefit for multimodality therapy in this cohort of patients.     

Cyclin D1 overexpression correlates with poor prognosis in patients with tongue squamous cell carcinoma

Tongue squamous cell carcinoma makes up a large percentage of head and neck cancers, and the incidence among young patients is increasing. The aim of this study was to reveal the correlation between cyclin D1 (CCND1) expression and clinical and histologic features. We performed an immunohistochemical study on the level of CCND1 expression in tumor specimens obtained from 94 patients with tongue squamous cell carcinoma. The relationship between the expression and the following features such as age, sex, smoking and alcohol intake history, T, N, histologic grade, and multiple primary cancer was analyzed. Eighteen patients (19%) showed CCND1 overexpression (tumor cell nuclei positivity >/=50%). The 5-year survival rate of high CCND1 expressors was 39%, which was significantly poor (p=0.04). N classification correlated with CCND1 expression. CCND1 overexpression is associated with poor survival associated with progression of lymph node spread in patients with tongue squamous cell carcinomas. CCND1 expression may be a useful biologic marker for prognosis.     

舌鳞状细胞癌的第二原发癌

目的评价口腔舌鳞状细胞癌中第二原发癌的发生及预后.方法回顾性分析1975～2000年329例口腔鳞状细胞癌患者的临床资料,生存患者的最短随诊时间为36个月.结果28例患者发生29个第二原发癌,其发生率为8.5%(28/329),其中包括2个同时第二原发癌(6.9%)、27个异时第二原发癌(93.1%).自舌癌确诊到异时第二原发癌确诊的平均时间为101(17～266)个月.23(79%)个第二原发癌发生于上气消化道,而食管是最常见的发生部位.发生于Ⅰ期病变9(11.8%)例、Ⅱ期病变10(10.8%)例、Ⅲ期病变9(6.7%)例,无一例发生于Ⅳ期病变,在临床分期之间,第二原发癌的发生率无明显区别.发生于T1病变11(13.4%)例、T2病变17(8.9%)例,无一例发生于T3和T4病变,在T1和T2病变间,第二原发癌的发生率无明显区别.在随诊期间,9例患者生存,19例患者死亡,其中死于第二原发癌14例.结论口腔舌鳞状细胞癌的第二原发癌并非不常见,食管为最常见的发生部位.第二原发癌易于发生在舌癌的早期病变,其预后较差.     

口腔鳞状细胞癌患者术后局部感染的危险因素

目的 探讨口腔鳞状细胞癌患者术后局部感染的危险因素.方法 收集275例口腔鳞状细胞癌患者的临床资料,统一制表并登记,统计病原学分析结果及一般资料,分析院内感染的危险因素.结果 90例口腔鳞状细胞癌术后局部感染患者中共分离出107株病原菌,主要为革兰阳性菌(59.81％),其中金黄色葡萄球菌(27.10％)较为常见;其次为革兰阴性菌(40.19％),其中铜绿假单胞菌(18.69％)较为常见.单因素分析结果显示,不同年龄、体重指数(BMI)、肿瘤部位、肿瘤直径、合并糖尿病情况、合并慢性阻塞性肺疾病情况、合并症数量、缺损修复方案、手术时间和输血情况的口腔鳞状细胞癌患者术后局部感染情况比较,差异均有统计学意义(P﹤0.05).多因素分析结果显示,年龄≥60岁、BMI﹤20 kg/m2、合并糖尿病、合并症数量﹥2个、缺损修复区域/游离皮瓣、手术时间﹥6 h均是口腔鳞状细胞癌患者术后局部感染的独立危险因素(P﹤0.05).结论 口腔鳞状细胞癌患者术后局部感染的危险因素较多,可通过充分术前评估尽可能地减少危险因素对口腔鳞状细胞癌患者造成的影响.     

Low p27 expression correlates with poor prognosis for patients with oral tongue squamous cell carcinoma

BACKGROUND: p27, a cyclin-dependent kinase inhibitor, regulates progression from G1 to S phase. There have been a few clinical reports of low p27 expression associated with poor survival among patients with cancer; however, there have been no reports of such an association in cases of head and neck cancer. The authors investigated whether p27 expression in patients with oral tongue squamous cell carcinoma was associated with their prognosis. METHODS: Ninety-four patients with oral tongue squamous cell carcinoma were analyzed. The authors performed p27 immunohistochemistry on all patients and Western blot analysis on 19 available patients. Cox proportional hazards regression analysis that included gender, history of smoking and alcohol usage, presence of multiple primary cancers, stage, histologic grade, and p27 status was used to identify the multivariate predictive value of prognostic factors. RESULTS: Twenty-six patients had high p27 expression (> or =50% tumor cell nuclei positive), and 68 patients had low p27 expression (<50%) by immunohistochemistry. In those with low p27 expression, N(+) and advanced T (T3 or T4) were significantly higher than in those with high p27 expression (P = 0.02 and 0.04). The 5-year survival rate in the low p27 group was 44%, whereas that in the high p27 group was 68%, indicating a significant difference (P = 0.04). p27 expression was inferred from Western blot analysis, and an arbitrary quantity (<1, 1-5, or > or =5) from the ratio of tumor to normal tissue density was used to characterize, resulting in 8 (42%), 3 (16%), and 8 (42%) patients in the low (<1-fold), intermediate (1-5-fold), and high (> or =5-fold) groups, respectively. Results of immunohistochemical analysis for p27 were significantly correlated with those of Western blot analysis (P = 0.02). Multivariate analysis revealed that low intensity of p27 expression and advanced stage (Stage III or IV) were predictors of reduced survival (P = 0.02 and 0.001). CONCLUSIONS: Low p27 expression was associated with increasing lymph node metastasis and stage of tumor and resulted in a poor prognosis for patients with oral tongue squamous cell carcinoma. p27 is apparently a significant predictor of survival.