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背景与目的:影响临床Ⅰ、Ⅱ期舌体鳞癌患者预后的因素很多,本文旨在探讨影响其预后的主要因素。方法:回顾性分析147例临床Ⅰ、Ⅱ期舌体鳞癌的长期随访资料,生存分析采用寿命表法,组间比较用log-rank检验,多因素分析采用Cox模型及Logistic回归分析。结果:单因素分析提示病理分级(中、低分化鳞癌)、颈淋巴结阳性、病理分期(Ⅲ、Ⅳ期)、饮酒史、原发灶复发、继发灶复发、原发灶和继发灶复发以及肿瘤复发均是影响预后的危险因素(P<0.05);多因素分析发现局部区域复发(P=0.000)和病理分期(P=0.045)影响预后;Logistic回归分析提示颈淋巴结阳性(P=0.003)和饮酒史(P=0.012)与局部区域复发显著相关。结论:影响临床Ⅰ、Ⅱ期舌体鳞癌预后的主要因素是局部区域复发和病理分期(Ⅲ、Ⅳ期),而颈淋巴结阳性和饮酒史是局部区域复发的危险因素。
BACKGROUND & OBJECTIVE: There are many factors that influence the prognosis of patients with tongue squamous cell carcinoma Ⅰ and Ⅱ. The purpose of this paper is to explore the main factors affecting the prognosis of tongue squamous cell carcinoma. Methods: The long-term follow-up data of 147 patients with stage I and II tongue squamous cell carcinoma were retrospectively analyzed. The survival analysis was performed by life table method. The log-rank test was used to compare the two groups. Cox regression model and Logistic regression analysis were used to analyze the multivariate analysis. Results: The univariate analysis showed that the pathological grade (moderate and poorly differentiated squamous cell carcinoma), cervical lymph node positive, pathological stage (Ⅲ, Ⅳ), alcohol consumption history, primary recurrence, secondary recurrence, primary and secondary Recurrence and tumor recurrence were both risk factors influencing prognosis (P <0.05). Multivariate analysis showed that recurrence in local area (P = 0.000) and pathological stage (P = 0.045) affected prognosis. Logistic regression analysis showed positive cervical lymph nodes (P = 0.003) and alcohol consumption history (P = 0.012) were significantly associated with regional recurrence. CONCLUSION: The main factors influencing the prognosis of tongue squamous cell carcinoma in stage Ⅰ and Ⅱ are local recurrence and pathological stage (stage Ⅲ and Ⅳ), while cervical lymph node positive and alcohol consumption are the risk factors of local recurrence.