喉癌三种不同颈淋巴结转移状态者生存率分析

目的比较喉癌三种不同颈淋巴结转移状态者的生存率以及它们在诸多影响喉癌预后的因素中的地位,提高对喉癌迟发性颈淋巴结转移的重视.方法回顾性分析336例喉癌的临床资料,分三组即初发性淋巴结转移、迟发性淋巴结转移和阴性淋巴结组,采用Kaplan-Meier法、COX模型分析结果 1.初发性、迟发性淋巴结转移和阴性淋巴结发生率分别是10.1%(34/336)、10.0%(33/336),76.5%(257/336).2.声门上型喉癌中初发、迟发和阴性淋巴结者的生存率的差异有统计学意义(Log Rank统计值=14.14,P=0.0009),其中初发组生存率低于阴性组(Wald=11.405,P=0.001),迟发组界于两者之间(初发组与迟发组比:Wald=3.338,P=0.068;迟发组与阴性组比:Wald=2.160,P=0.142);声门型喉癌中三组生存率的差异也有统计学意义(Log Rank统计值=32.70,P=0.0000),其中初发组生存率与迟发组无统计学差异(Wald=0.916,P=0.339),迟发组和初发组生存率都低于阴性组(Wald分别是25.832和4.030,P分别是0.000和0.045).3.在诸多影响喉癌预后的因素中,初发性和迟发性淋巴结转移是最重要的.结论喉癌颈淋巴结转移者生存率低,迟发性颈淋巴结转移对生存率有负面影响,并且在众多影响因素中,淋巴结转移状态包括初发和迟发性淋巴结转移最重要.

The comparison of survival rate among the different lymph node metastatic statuses in laryngeal carcinoma

Objective The aim of this study is to compare the survival rates among three different lymph node metastatic status in laryngeal carcinoma as well as there status' role affecting the prognosis of laryngeal carcinoma.Methods The clinical data of 336 cases with laryngeal cancer were analyzed retrospectively,and the Kaplan-Meier method was used to analyze the survival rates among the initiated,delayed and negative lymph node metastasis groups and the affecting factors were analyzed by COX regression model.Results 1.The rates of initiated lymph node metastasis,delayed lymph nodes metastasis and negative neck were 10.1%(34/336),10.0%(33/336) and 76.5%(257/336) respectively.2.The survival curve were significantly different among the initiated,delayed and negative lymph node metastastic group in the supraglottic laryngeal cancer(Log Rank=14.14, P =0.0009),the survival rate of the initiated group was lower than that of negative groups(Wald=11.405, P =0.001),but the survival rate of the delayed group was in the middle between the initiated and negative group(when compared with initiated group:Wald=3.338, P =0.068;when compared with negative group:Wald=2.160, P =0.142);The survival curve among the three groups were significantly different either in the glottic cancer(Log Rank=32.70, P =0.0000),the difference of survival rates between initiated and delayed groups was insignificant(Wald=0.916, P =0.339),both of them were lower than that of negative group(Wald were 5.832 and 4.030 respectively,P were 0.000 and 0.045respectively) 3.Both the initiated and delayed lymph node metastases were the best important factors affecting the survival rate in laryngeal cancer.Conclusion The survival rate of those with lymph nodes metastases was lower and the kinds of metastasis including initiated and delayed metastasis are the best important factors affecting the survival rate of laryngeal carcinoma.