喉部分切除术治疗喉癌的疗效及影响因素分析

目的：探讨喉部分切除术(PLR)治疗喉癌的疗效及其影响因素。方法选取我院耳鼻咽喉-头颈外科2009年3月至2011年1月收治的128例喉癌患者，从手术日起通过电话、门诊复查等方式随访5年，统计患者5年生存率，以年龄、病理分级、切除术式、TNM分期等临床指标作为影响因素，以喉癌患者5年生存率为因变量进行单因素分析，差异有统计学意义者再进行Logistic多因素回归分析。结果本组患者均随访5年，1年、3年、5年生存率分别为96.88%(124/128)、75.00%(96/128)、66.41%(85/128)。单因素分析显示，淋巴结转移、肿瘤大小、TNM分期、原发部位、颈部淋巴结清扫、吸烟史、病理分级对喉癌患者术后5年生存率具有显著相关性(P<0.05)；多因素分析显示，TNM分期、吸烟史、原发部位、淋巴结转移是影响喉癌患者手术预后存活的独立危险因素(P<0.05)。结论影响喉癌患者术后疗效的高危因素是TNM分期、吸烟史、原发部位、淋巴结转移，因此临床工作者应对喉癌患者早诊断、早治疗，以改善预后。

Analysis of curative effect and influence factors of laryngeal partial resection in treatment of laryngeal carcinoma

Objective To investigate the curative effect and influencing factors of laryngeal resection partial (PLR) in the treatment of laryngeal carcinoma. Methods A total of 128 patients with laryngeal carcinoma in Depart-ment of Otorhinolaryngology Head and Neck Surgery in Central People's Hospital of Huizhou were selected from March 2009 to January 2011. The patients were followed up for 5 years from the day of surgery through telephone, outpatient re-view, and the 5-year survival rates of patients were recorded. The clinical data of age, pathological grading, surgical re-section, TNM staging were used as the influencing factors and the 5-year survival rate of patients was used as dependent variable for univariate analysis. The factors with statistically significant difference were further used for logistic multi-factor regression analysis. Results The patients were followed up for 5 years, and the 1-year, 3-year, 5-year sur-vival rate was 96.88% (124/128), 75.00% (96/128), 66.41% (85/128), respectively. Single factor analysis showed that lymph node metastasis, tumor size, TNM stage, primary site, neck lymph node dissection, smoking history, pathological grading had significant correlation with 5-year survival rate of the patients (P<0.05). Multi-factor regression analysis showed that TNM stage, smoking history, primary site, lymph node metastasis were the independent risk factors for sur-vival of patients with laryngeal carcinoma (P<0.05). Conclusion The high risk factors for clinical effect of patients with laryngeal cancer are TNM stage, smoking history and primary site, lymph node metastasis. Thus, clinical workers should treat laryngeal carcinoma patients with early diagnosis, early treatment, to improve the prognosis.