【作者】 余琼；

【导师】 胡国华；

【作者基本信息】 重庆医科大学 ， 耳鼻咽喉科学， 2010， 硕士

【摘要】 目的:探讨喉癌的自然生存率及其影响因素。方法:回顾性分析2000年1月1日至2007年12月31日188例未行喉切除术及放化疗治疗的喉癌患者的临床资料,包括年龄、吸烟史、肿瘤家族史、结核病史、肿瘤生长部位、病理学分级、T分期、N分期、临床分期以及有无气管切开术史。应用Kaplan-Meier乘极限法计算生存率,单因素分析组间比较采用Log-rank检验,多因素分析采用Cox比例风险模型。结果:总的中位生存时间为14±1.47月,1年、2年、5年生存率分别为54.7%、26.6%、11.0%;确诊超过5年的病例(除失访者外)尚无一例生存超过5年。0/Ⅰ/Ⅱ期中位生存时间为33±5.72月,1年、2年生存率分别为75.1%、57.9%;Ⅲ/Ⅳ期中位生存时间为10±1.31月,1年、2年生存率分别为43.2%、11.4%。单因素分析显示肿瘤生长部位、病理学分级、T分期、N分期、临床分期对生存率的影响有统计学意义(P<0.05),而是否行气管切开术无统计学意义。多因素分析显示病理学分级、临床分期对生存率的影响有统计学意义(P<0.05)。结论:喉癌自然病程发展较快,在未针对肿瘤本身治疗的情况下,即便行姑息性手术如气管切开术亦不能提高生存率;影响喉癌自然生存率的因素为肿瘤生长部位、病理学分级、T分期、N分期、临床分期,其中独立危险因素为病理学分级和临床分期。更多还原

【Abstract】 Objective To investigate the factors affecting the natural survival rates of laryngeal carcinoma.Methods January 1,2000 to December 31,2007,one hundred and eighty eight laryngeal carcinoma cases without laryngectomy、radiotherapy and chemotherapy were analyzed restrospectively,including age,smoking,tumor family history,tuberculosis history,primary site, pathological grade,T-stage,N-stage,clinical stage and if had performed tracheotomy.Survival rates was calculated by Kaplan-Meier product-limit method.On univariate analysis,comparison among/between groups was performed using Log-rank test.Multivariate analysis was carried out using Cox proportional hazard model.Results Overall median survival time was 14±1.47 months,overall 1-,2-,5-year survival rates were 54.7%,26.6%,11.0%,respectively.No patient survived over 5 years in these cases diagnosed more than 5 years (except for those who lost).The median survival time of 0/Ⅰ/Ⅱclinical stages was 33±5.72 months, 1-,2-year survival rates were 75.1%、 57.9%,respectively;the median survival time ofⅢ/Ⅳclinical stages was 10±1.31 months,1-,2-year survival rates were 43.2%、11.4%,respectively. Univariate analysis showed that primary site,pathological grade, T-stage, N-stage and clinical stage were proven to significant(P<0.05).If had performed tracheotomy that was nonsignificant to affect survival rates. Multivariate analysis showed survival rates statistically correlated with pathological grade and clinical stage(P<0.05).Conclusion The development of laryngeal carcinoma natural course was faster, without treatment to the tumor itself, even if palliative surgical such as tracheostomy would not improve the survival rate;The factors affecting the natural survival rates of the patients with laryngeal carcinoma are primary site,pathological grade, T-stage, N-stage and clinical stage,the independent affecting factors are pathological grade and clinical stage.更多还原