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目的:从喉癌肿瘤标志物、喉癌分子切缘以及临床因素三个方面分析喉癌复发的相关因素。方法:应用免疫组织化学方法检测喉癌复发组与未复发组原发灶、喉癌外科切缘的CyclinD1、p27、p53以及eIF4E表达状况,通过回顾性分析103例喉癌的临床资料,探讨喉癌复发的临床因素;并综合三方面因素对喉癌复发进行多因素分析。结果:喉癌术后复发组与未复发组原发灶的CyclinD1、p27、p53表达差异均有统计学意义(均P<0.05),eIF4E表达差异无统计学意义(P>0.05)。两组切缘的CyclinD1、p27、p53、eIF4E表达差异均有统计学意义(均P<0.05),喉癌复发组eIF4E切缘阳性表达率高于CyclinD1、p27和p53。喉癌术后复发与原发肿瘤部位、T分期、淋巴结转移、喉癌病理分化程度以及首次手术方式有关;与年龄、性别、是否术后放疗无关。Logitic多因素回归分析显示:喉癌术后复发与肿瘤T分期、淋巴结转移、喉癌病理分化程度以及首次手术方式有关。综合肿瘤标志物、喉癌分子切缘以及临床因素三个方面的Logistic多因素回归分析显示:喉癌术后复发与喉癌T分期、颈部淋巴结转移、病理分化程度以及分子切缘阳性有关。结论:影响喉癌术后复发的因素复杂多样;喉癌T分期高、有颈部淋巴结转移、病理分化程度差以及分子切缘阳性者术后容易复发;喉癌分子切缘阳性是更为敏感的喉癌复发因素。
Objective: To analyze the related factors of laryngeal cancer recurrence from three aspects: tumor markers of laryngeal cancer, molecular margin of laryngeal cancer and clinical factors. Methods: Immunohistochemistry was used to detect the expression of CyclinD1, p27, p53 and eIF4E in primary laryngeal cancer and laryngeal cancer at laryngeal cancer recurrence group and non-recurrence group. The clinical data of 103 laryngeal cancer patients were retrospectively analyzed. Cancer recurrence of clinical factors; and comprehensive three factors on the recurrence of laryngeal cancer by multivariate analysis. Results: The expressions of CyclinD1, p27 and p53 in primary laryngeal cancer patients with recurrent laryngeal cancer and non - recurrent laryngeal cancer patients were significantly different (all P <0.05). The expression of eIF4E had no statistical significance (P> 0.05). The expression of CyclinD1, p27, p53 and eIF4E at the margin of the two groups were significantly different (all P <0.05). The positive expression of eIF4E in laryngeal cancer recurrence group was higher than that of CyclinD1, p27 and p53. Postoperative recurrence of laryngeal cancer and the primary tumor site, T stage, lymph node metastasis, the degree of pathological differentiation of laryngeal cancer and the first surgical approach; with age, gender, whether postoperative radiotherapy has nothing to do. Logitic multivariate regression analysis showed that the recurrence of laryngeal cancer was related to T stage, lymph node metastasis, pathological differentiation of laryngeal carcinoma and the first operation. Logistic multivariate regression analysis showed that the recurrence of laryngeal carcinoma was related to T stage, lymph node metastasis, pathological differentiation and positive margins of laryngeal cancer. Conclusions: The factors influencing the recurrence of laryngeal carcinoma are complex and diverse. The high T stage of laryngeal carcinoma, the metastasis of cervical lymph nodes, the poor differentiation of pathology and the positive molecular cut-off are more likely to relapse after operation. Positive margin of laryngeal carcinoma is more sensitive Of laryngeal cancer recurrence factors.