论文部分内容阅读
目的:探讨影响舌鳞状细胞癌患者术后生存的相关因素。方法:回顾性分析经病理确诊并行手术治疗的44例舌鳞癌患者临床资料,采用免疫组织化学方法检测不同病理分级舌鳞癌患者癌组织中CXCR4、CD44、CD133的表达情况。将可能影响患者术后生存的指标进行Kaplan-Meier检验后,采用Cox比例风险回归模型进行多因素分析。结果:本研究44例舌鳞癌标本中,高分化29例,中、低分化15例;Ⅰ期11例,Ⅱ期12例,Ⅲ期8例,Ⅳ期13例。各病理分级病例CXCR4、CD44、CD133阳阳性率分别是79.54%(35/44)、77.27%(34/44)和75.00%(33/44)。CXCR4、CD44、CD133在舌鳞癌各病理分级组在之间表达强度差异均有统计学意义(P<0.05),且CXCR4、CD44、CD133分别与转移、复发也成正相关。Cox模型多因素分析提示:CXCR4表达情况、临床分期、颈部转移为本组舌鳞癌患者预后独立的影响因素及死亡的危险因素。结论:CXCR4、CD44、CD133的表达与舌鳞癌的恶性程度存在相关性,CXCR4表达情况、临床分期、颈部转移为术后评价舌鳞癌患者生存的重要指标。
Objective: To investigate the related factors that affect the postoperative survival of patients with tongue squamous cell carcinoma. Methods: The clinical data of 44 patients with tongue squamous cell carcinoma confirmed by pathology were analyzed retrospectively. The expression of CXCR4, CD44 and CD133 in different pathological grades of tongue squamous cell carcinoma were detected by immunohistochemistry. After Kaplan-Meier test, the indexes that may affect the postoperative survival of patients were analyzed by multivariate Cox proportional hazards regression model. Results: Totally 44 cases of tongue squamous cell carcinoma were well differentiated in 29 cases and moderately and poorly differentiated in 15 cases. There were 11 cases in stage Ⅰ, 12 cases in stage Ⅱ, 8 cases in stage Ⅲ and 13 cases in stage Ⅳ. The positive rates of CXCR4, CD44 and CD133 in all pathological grading cases were 79.54% (35/44), 77.27% (34/44) and 75.00% (33/44), respectively. The expressions of CXCR4, CD44 and CD133 in tongue squamous cell carcinoma were significantly different (P <0.05), and CXCR4, CD44 and CD133 were also positively correlated with metastasis and recurrence respectively. Multivariate analysis of Cox model suggested that the expression of CXCR4, clinical stage and neck metastasis were independent prognostic factors and risk factors for death in patients with TSCC. Conclusion: There is a correlation between the expression of CXCR4, CD44 and CD133 and the malignancy of tongue squamous cell carcinoma. The expression of CXCR4, clinical stage and neck metastasis are the important indexes for evaluating the survival of patients with TSCC.