68例下颌牙龈鳞癌预后影响因素分析

中国口腔颌面外科杂志 ›› 2014, Vol. 12 ›› Issue (6): 530-534.

68例下颌牙龈鳞癌预后影响因素分析

杨洪^{1, 2}, 宋晓萌¹, 陈洁¹, 杨学明¹, 储伟明¹, 吴煜农¹

1.南京医科大学口腔医学研究所,南京医科大学附属口腔医院口腔颌面外科,江苏南京 210000;
2.马鞍山市中心医院口腔科,安徽马鞍山 243000

收稿日期:2014-08-14 出版日期:2014-11-10 发布日期:2015-01-01
通讯作者: 吴煜农,Tel:025-85031871,E-mail：wynoms@gmail.com.
作者简介:杨洪(1977-),男,硕士,主治医师,E-mail:

Analysis of prognostic factors in lower gingival squamous cell carcinoma

YANG Hong, SONG Xiao-meng, CHEN Jie, YANG Xue-ming, CHU Wei-ming, WU Yu-nong

1.Institute of Stomatology, Nanjing Medical University;
Department of Oral and Maxillofacial Surgery, School of Stomatology, Nanjing Medical University. Nanjing 210000, Jiangsu Province;
2. Department of Stomatology, Maanshan Central Hospital. Maanshan 243000, Anhui Province, China

Received:2014-08-14 Online:2014-11-10 Published:2015-01-01

摘要/Abstract

摘要： 目的通过对68例下颌牙龈鳞癌患者的回顾性研究,分析影响下颌牙龈鳞癌预后的因素。方法对江苏省口腔医院口腔颌面外科2003—2012年收治的68例下颌牙龈鳞癌患者进行回顾分析,利用SPSS 20.0软件包进行Kaplan-Meier生存分析,计算术后3年、5年的生存率（overall survival rate, OSR）;采用单因素Log-rank及多因素Cox回归进行生存分析。结果 68例患者的3年、5年OSR分别为77.2%、72.3%。单因素Log-rank分析结果表明,肿瘤颊、舌侧位置,颈淋巴结转移及术后复发与患者预后显著相关（P<0.05）。多因素Cox回归分析显示,肿瘤颊、舌侧部位,颈淋巴结转移与局部复发是5年生存率的独立预后因素（P<0.05）。结论在下颌牙龈鳞癌中,肿瘤颊、舌侧位置,局部复发,颈淋巴结阳性与患者预后相关,是影响生存率的重要因素。

关键词: 下颌, 牙龈, 鳞状细胞癌, 生存, 预后

Abstract: PURPOSE : To analyze the factors of affecting prognosis by using retrospective study of 68 cases of squamous cell carcinoma (SCC) of the mandibular gingiva. METHODS : A retrospective study of 68 cases of SCC in the mandibular gingiva were carried out, all cases were from Department of Oral and Maxillofacial Surgery, School of Stomatology, Nanjing Medical University from 2003 to 2012. Kaplan-Meier survival analysis was used to evaluate 3- and 5-year overall survival rate (OSR), factors of affecting prognosis were analyzed by using univariate Log-rank and multivariate Cox regression survival analysis with SPSS 20.0 software package. RESULTS : Sixty-eight patients were included in the study, the 3- and 5-year OSR were 77.2% and 72.3%. Univariate Log-rank analysis showed that tumor location in the buccal or lingual side, cervical lymph node metastasis and recurrence were significantly related to survival rate (P<0.05). Multivariate Cox regression analysis showed that tumor location in the buccal or lingual side, lymph node metastasis and local recurrence were independent prognostic factors of OSR (P<0.05). CONCLUSIONS : In SCC of the mandibular gingiva, tumor location in the buccal or lingual side, cervical lymph node metastasis and recurrence were significantly related to survival rate and were independent prognostic factors of OSR.

Key words: Mandible, Gingiva, Squamous cell carcinoma, Survival, Prognosis

中图分类号:

R739.8

杨洪, 宋晓萌, 陈洁, 杨学明, 储伟明, 吴煜农. 68例下颌牙龈鳞癌预后影响因素分析[J]. 中国口腔颌面外科杂志, 2014, 12(6): 530-534.

YANG Hong^{1, 2}, SONG Xiao-meng¹, CHEN Jie¹, YANG Xue-ming¹, CHU Wei-ming¹, WU Yu-nong¹. Analysis of prognostic factors in lower gingival squamous cell carcinoma[J]. China J Oral Maxillofac Surg, 2014, 12(6): 530-534.

参考文献

[1] Yoon TY, Bhattacharyya I, Katz J, et al. Squamous cell carcinoma of the gingiva presenting as localized periodontal disease [J]. Quintessence Int, 2007, 38(2): 97-102.
[2] Fitzpatrick SG, Neuman AN, Cohen DM, et al. The clinical and histologic presentation of gingival squamous cell carcinoma: a study of 519 cases [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(4): 509-515.
[3] Yokoo S, Umeda M, Komatsubara H, et al. Evaluation of T-classifications of upper gingival and hard palate carcinomas a proposition for new criterion of T4 [J]. Oral Oncol, 2002, 38(4): 378-382.
[4] Overholt SM, Eicher SA, Wolf P, et al. Prognostic factors affecting outcome in lower gingival carcinoma [J]. Laryngoscope, 1996, 106(11): 1335-1339.
[5] Mourouzis C, Pratt C, Brennan PA. Squamous cell carcinoma of the maxillary gingiva, alveolus, and hard palate: is there a need for elective neck dissection?[J]. Br J Oral Maxillofac Surg, 2010, 48(5): 345-358.
[6] Beltramini GA, Massarelli O, Demarchi M, et al. Is neck dissection needed in squamous-cell carcinoma of the maxillary gingiva, alveolus, and hard palate? A multicentre Italian study of 65 cases and literature review [J]. Oral Oncol,2012,48(2):97-101.
[7] Mourouzis C, Pratt C, Brennan PA. 上颌牙龈、牙槽骨、硬腭鳞状细胞癌:选择性颈淋巴清扫术是否需要?[J]. 中国口腔颌面外科杂志, 2009, 7(5): 400.
[8] Lubek J, El-Hakim M, Salama AR, et al. Gingival carcinoma: retrospective analysis of 72 patients and indications for elective neck dissection[J]. Br J Oral Maxillofac Surg,2011,49(3):182-185.
[9] Gomez D, Faucher A, Picot V, et al. Outcome of squamous cell carcinoma of the gingiva: a follow-up study of 83 cases[J]. J Craniomaxillofac Surg, 2000, 28(6): 331-335.
[10] Seoane J, Varela-Centelles PI, Walsh TF, et al. Gingival squamous cell carcinoma: diagnostic delay or rapid invasion?[J]. J Periodontol, 2006, 77(7): 1229-1233.
[11] Nomura T, Shibahara T, Cui NH, et al. Patterns of mandibular invasion by gingival squamous cell carcinoma [J]. J Oral Maxillofac Surg, 2005, 63(10): 1489-1493.
[12] Nakayama E, Yoshiura K, Yuasa K, et al. A study of the association between the prognosis of carcinoma of the mandibular gingiva and the pattern of bone destruction on computed tomography [J]. Dentomaxillofac Radiol, 2000, 29(3): 163-169.
[13] Ebrahimi A, Murali R, Gao K, et al. The prognostic and staging implications of bone invasion in oral squamous cell carcinoma [J]. Cancer, 2011, 117(19): 4460-4467.
[14] Tei K, Totsuka Y, Iizuka T, et al. Marginal resection for carcinoma of the mandibular alveolus and gingiva where radiologically detected bone defects do not extend beyond the mandibular canal [J]. J Oral Maxillofac Surg, 2004, 62(7): 834-839.
[15] Nakayama E, Yoshiura K, Ozeki S, et al. The correlation of histologic features with a panoramic radiography pattern and a computed tomography pattern of bone destruction in carcinoma of the mandibular gingival [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 96(6): 774-782.
[16] Quan J, Johnson NW, Zhou G, et al. Potential molecular targets for inhibiting bone invasion by oral squamous cell carcinoma: a review of mechanisms [J]. Cancer Metastasis Rev, 2012, 31(1-2): 209-219.
[17] Close LG, Merkel M, Burns DK, et al. Computed tomography in the assessment of mandibular invasion by intraoral carcinoma [J]. Ann Otol Rhinol Laryngol, 1986, 95(4 Pt 1): 383-388.
[18] 段青云, 贾暮云, 张雄, 等. CT和SPECT对下牙龈癌侵犯下颌骨诊断价值的比较 [J]. 上海口腔医学, 2008, 17(5): 471-474.
[19] Weiss MH, Harrison LB, Isaacs RS. Use of decision analysis in planning a management strategy for the stage N0 neck [J]. Arch Otolaryngol Head Neck Surg, 1994, 120(7): 699-702.
[20] Kimura Y, Sumi M, Sumi T, et al. Deep extension from carcinoma arising from the gingiva: CT and MR imaging features [J]. AJNR Am J Neuroradiol, 2002, 23(3): 468-472.