179例喉鳞状细胞癌临床病理特征及预后因素的回顾性研究OACSTPCD
A retrospective study on clinicopathological features and prognostic factors of 179 cases of laryngeal squamous cell carcinoma
目的 分析喉鳞状细胞癌(laryngeal squamous cell carcinoma,LSCC)患者的临床病理特征及与预后的相关性,以提高对LSCC的认识和诊断率.方法 回顾性分析2015年1月~2022年12月在宁夏医科大学第一和第二临床医学院两家三级甲等医院耳鼻咽喉头颈外科接受治疗的179例LSCC患者,其中男171例,女8例,年龄30~84(61.53±8.02)岁,病理学资料包括性别、年龄、临床分期、分化程度、免疫组化结果等,并分析各因素对预后的影响.结果 179例LSCC患者中男女比为21.4∶1,60~79岁年龄段高发(58.7%),发病年龄最小者30岁;主要临床表现为声嘶138例(77.1%)、咽痛16例(8.9%)及咽部异物感13例(7.3%);原发部位以声门型多见135例(75.4%),31例(17.3%)伴有颈部淋巴结转移.分化程度以中分化型多见80例(44.7%);免疫组化标志物p16、表皮生长因子受体(epidermal growth factor receptor,EGFR)、PD-1/PD-L1、血管内皮生长因子(vascular endothelial growth factor,VEGF)阳性率分别为20.3%、96.4%、36.4%、77.3%.单因素Kaplan-Meier生存分析结果显示:临床分期、发病部位及淋巴结转移与疾病复发显著相关;多因素Cox回归分析结果显示:肿瘤临床分期是该疾病预后的独立危险因素(HR=3.715,95%CI:1.519~9.088,P=0.04).结论 LSCC临床分期、发病部位、淋巴结转移是影响预后的主要因素.免疫组化标志物EGFR和VEGF阳性表达率较高值得关注.检测PD-1/PD-L1阳性患者的靶向治疗是一个有前景的研究方向.
OBJECTIVE To analyze the clinicopathological features of laryngeal squamous carcinoma tumors and their correlation with prognosis in order to improve the understanding and diagnosis of laryngeal squamous cell carcinoma.METHODS The clinical and pathological data(including gender,age,stage,differentiation,immunohistochemistry,etc.)of 179 patients with laryngeal squamous cell carcinoma[171 males,8 females,aged 30-84(61.53±8.02)years]who were treated in Department of Otolaryngology Head and Neck Surgery,The First and Second Clinical Medical Schools of Ningxia Medical University from January 2015 to December 2022 were retrospectively studied,and the effects of various factors on prognosis were analyzed.RESULTS Among the 179 patients with laryngeal squamous cell carcinoma,the male-to-female ratio was 21.4:1,and the incidence was high in the age group of 60-79 years old(58.7%),and the youngest age of onset was 30 years old.The main clinical manifestations were hoarseness 138 cases(77.1%),sore throat 16 cases(8.9%)and pharyngeal foreign body sensation 13 cases(7.3%).Glottic type was more common in the primary site 135 cases(75.4%),and 31 cases were accompanied by cervical lymph node metastasis(17.3%).The degree of differentiation was more common in the moderately differentiated type 80 cases(44.7%).The positive rates of immunohistochemistry markers p16,EGFR(epidermal growth factor receptor),PD-1/PD-L1 and VEGF(vascular endothelial growth factor)were 20.3%,96.4%,36.4%and 77.3%,respectively.Univariate Kaplan-Meier survival analysis showed that the site of disease,lymph node metastasis,and tumor stage were significantly correlated with disease recurrence.Multivariate Cox regression analysis showed that the clinical stage of the tumor was an independent risk factor for the prognosis of the disease(HR=3.715,95%CI:1.519-9.088,P=0.04).CONCLUSION The stage of laryngeal squamous cell carcinoma,the site of the disease,and the metastasis of the lymph nodes are the main factors affecting the prognosis.The high positive expression rate of immunohistochemistry markers EGFR and VEGF is worth paying attention to Targeted therapy for patients with positive PD-1/PD-L1 testing is a promising research direction.
弥志鹏;李永春;文武林;申学良;杨凤霞;杨梅花;章峪侨;陈宝丽;马瑞霞
宁夏医科大学第二临床医学院,宁夏 银川 750001银川市第一人民医院耳鼻咽喉头颈外科,宁夏 银川 750001银川市第一人民医院耳鼻咽喉头颈外科,宁夏 银川 750001银川市第一人民医院耳鼻咽喉头颈外科,宁夏 银川 750001银川市第一人民医院耳鼻咽喉头颈外科,宁夏 银川 750001宁夏医科大学第二临床医学院,宁夏 银川 750001宁夏医科大学第二临床医学院,宁夏 银川 750001宁夏医科大学第二临床医学院,宁夏 银川 750001银川市第一人民医院耳鼻咽喉头颈外科,宁夏 银川 750001
喉肿瘤癌,鳞状细胞预后临床特征病理特征回顾性分析
Laryngeal NeoplasmsCarcinoma,Squamous CellPrognosisclinical featurespathological featureretrospective analysis
《中国耳鼻咽喉头颈外科》 2024 (11)
686-691,6
银川市科技计划项目(2024SFZD003)宁夏回族自治区重点研发计划项目(2018YBZD0145、2022BEG03103)
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