中国耳鼻咽喉头颈外科2025，Vol.32Issue(6)：348-353,6.DOI:10.16066/j.1672-7002.2025.06.002
晚期肺癌炎症指数对喉鳞状细胞癌术后咽瘘、复发转移及预后的预测价值研究
The predictive value of advanced lung cancer inflammation index for postoperative pharyngocutaneous fistula,recurrence,metastasis,and prognosis in laryngeal squamous cell carcinoma
摘要
Abstract
OBJECTIVE To investigate the predictive value of the advanced lung cancer inflammation index(ALI)for postoperative pharyngocutaneous fistula,recurrence,metastasis,and prognosis in patients with laryngeal squamous cell carcinoma(LSCC).METHODS This retrospective study analyzed the clinical data of 114 LSCC patients treated at Huangshi Central Hospital between January 2014 and December 2023.The data included tumor staging,ALI scores,age,gender,smoking history,alcohol history,diabetes,hypertension,hyperlipidemia,coronary heart disease,tumor differentiation,HPV infection,and tumor location.Based on the occurrence of pharyngocutaneous fistula,the patients were divided into the fistula group(10 cases)and the non-fistula group(104 cases).Single-factor and multi-factor logistic regression analyses were conducted to identify independent factors associated with postoperative pharyngocutaneous fistula.Patients were also classified into recurrence and metastasis groups(22 cases)and non-recurrence groups(92 cases),and further into poor prognosis(25 cases)and good prognosis groups(89 cases)based on follow-up results.Cox regression analysis was performed to identify factors influencing recurrence,metastasis,and prognosis.RESULTS Multivariate logistic regression analysis showed that tumor stage(stage Ⅰ-Ⅱ)[HR:0.040(95％CI:0.004-0.392)]and ALI score[HR:0.885(95％CI:0.805-0.972)]were independent protective factors for the occurrence of pharyngeal fistula(P<0.05).Multivariate Cox regression analysis further confirmed that tumor stage(stage Ⅰ-Ⅱ)[OR:0.180(95％CI:0.063-0.518)]and ALI score[OR:0.970(95％CI:0.939-0.992)]were independent protective factors for recurrence,metastasis,and poor prognosis(P<0.05).ROC curve analysis revealed that the AUC for ALI in predicting pharyngeal fistula was 0.910(95％CI:0.849-0.970),with a cutoffvalue of 29.877,sensitivity of 0.827,and specificity of 1.000.The AUC for ALI in predicting recurrence and metastasis was 0.804(95％CI:0.698-0.910),with a cutoffvalue of 34.398,sensitivity of 0.920,and specificity of 0.618.CONCLUSION The ALI score is an independent protective factor for the occurrence of postoperative pharyngocutaneous fistula,recurrence,metastasis,and poor prognosis in LSCC patients.It is a valuable predictor for early warning of postoperative complications,recurrence,metastasis,and prognosis,with potential clinical utility in guiding personalized treatment strategies.关键词
喉肿瘤/癌,鳞状细胞/复发/预后/晚期肺癌炎症指数/咽瘘/转移Key words
Laryngeal Neoplasms/Carcinoma,Squamous Cell/Recidivism/Prognosis/advanced lung cancer inflammation index/pharyngocutaneous fistula/metastasis引用本文复制引用
程攀,岑瑞祥,刘丹,曹炜..晚期肺癌炎症指数对喉鳞状细胞癌术后咽瘘、复发转移及预后的预测价值研究[J].中国耳鼻咽喉头颈外科,2025,32(6):348-353,6.基金项目
湖北省自然基金(2022CFB498) （2022CFB498）
湖北省自然科学基金创新发展联合基金(2024AFD028) （2024AFD028）
黄石市卫生健康科研项目面上项目(WJ2024014) （WJ2024014）
