摘要
目的 探讨颈部淋巴结阳性枚数、阳性分区数和阳性比例与下咽癌患者预后的关系.方法 回顾性分析2000年1月至2005年12月行肿瘤根治术联合颈淋巴清扫术的81例下咽鳞癌患者的临床病理特征,分析颈部淋巴结清扫术后阳性淋巴结枚数、阳性分区数和阳性比例与患者预后的关系.结果 81例下咽癌患者的颈部淋巴结转移率为79.0％ （64/81）,其中单颈淋巴转移率为82.9％ （53/64）,双颈淋巴转移率为17.1％ （11/64）,随着T分期增加,颈部淋巴结转移率增加.阳性颈部淋巴结枚数为0、1～3枚、≥4枚患者的中位生存时间分别为81、51和26个月（P＜0.01）.阳性淋巴结分区数为0、1～2区、≥3区患者的中位生存时间分别为84、45和23个月（P＜0.01）.阳性淋巴结比例为0、＜10％、≥10％患者的中位生存时间分别为84、51和17个月（P＜0.01）.多因素分析显示,阳性淋巴结比例、肿瘤T分期、淋巴结包膜侵犯和治疗模式为影响患者预后的独立因素（P=0.002）.结论 颈部淋巴结阳性比例可作为预测下咽癌患者预后的独立因素.
Objective To explore the relationship between positive lymph node number,involved region,positive lymph node ratio and the prognosis of patients with hypopharyngeal cancer.Methods Clinicopatological data of 81 patients with hypopharyngeal squamous cell carcinoma who underwent hypopharyngectomy and cervical lymph node dissection from January 2000 to December 2005 in our hospital were analyzed retrospectively.The relationship between positive lymph node number,involved region,positive lymph node ratio and the prognosis was analyzed.Results The rate of lymph node metastasis was 79.0％ （64/81） in the 81 patients with hypopharyngeal cancer.Of which,the rates of unilateral metastasis and bilateral metastasis were 82.9％ （53/64） and 17.1％ （11/64）,respectively.The rate of lymph node metastasis was increasing with advancing tumor stage.The median survival times were 81,51 and 26 months in the patients with 0,1-3 and ≥4 positive lymph nodes,respectively （P ＜ 0.001）,84,45 and 23 months in patients with 0,1-2 and ≥3 involved regions,respectively （P ＜0.001）,and 84,51 and 17 months in patients with positive lymph node ratio of 0,＜ 10％ and ≥ 10％,respectively （P ＜ 0.001）.Multivariable analysis showed that positive lymph node ratio,extracapsular infiltration,T classification and treatment modality were independent prognostic factors （P =0.002）.Conclusions Positive lymph node ratio is an independent prognostic factor for hypopharyngeal cancer.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2014年第10期783-787,共5页
Chinese Journal of Oncology
关键词
下咽肿瘤
淋巴结
转移淋巴结比例
预后
Hypopharyngeal neoplasm
Lymph nodes
Metastatic lymph node ratio
Prognosis
