波多黎各人头颈部鳞状细胞癌的临床病理特征

Busquets José M, García Hector A, Trinidad-Pinedo Juan, Baez Adriana

Department of Otolaryngology-Head & Neck Surgery, Medical Sciences Campus, University of Puerto Rico.

P R Health Sci J. 2003 Sep;22(3):259-64.

OBJECTIVE

The purpose of this study is to characterize head and neck squamous cell carcinoma (HNSCC) in the Puerto Rican population. This is a follow-up to our initial published report on the first 134 patients. Specifically, demographic characteristics, stage at presentation, initial treatment given, and rate of recurrence were studied.

METHODS

Relevant data was obtained from 445 histologically confirmed HNSCC cases identified through the University of Puerto Rico School of Medicine Otolaryngology Department Head and Neck Cancer Clinics between August 1993 and January 2003. Data collected after informed consent included demographic factors (sex, age, areas of residence, income); risk factors (occupation, alcohol intake, cigarette usage); and pathological variables (tumor location, histopathology, stage at presentation, current disease status, tumor recurrence).

RESULTS

The average age at diagnosis was 64.0 years (range 18-98); 84.5% of the patients were male, 16% were females. The most frequent anatomical sites of the primary tumor were the larynx (36.4%) and the oral cavity (29.9%). The majority of patients (61.1%) presented with advanced stage (III-IV) disease at the time of diagnosis and over half (55.5%) had moderately-differentiated tumors. Most patients had less than 12 years of formal education (81.2%). Prolonged use of tobacco and alcohol identified in 88.1% and 79.8% of patients, respectively. The most frequent therapeutic modality used was radiation therapy followed by the combination of radiation and surgery. Twenty five percent of the cases experienced a recurrence of disease during the follow-up period.

CONCLUSIONS

These findings emphasize the need for early detection programs for HNSCC in Puerto Rican patients given the high rate of advanced-stage disease at time of diagnosis. The key role of heavy alcohol intake and tobacco use as risk factors in the development of HNSCC is once again highlighted.

目的

本研究旨在描述波多黎各人群头颈部鳞状细胞癌（HNSCC）的特征。这是对我们最初发表的关于前134例患者报告的后续研究。具体而言，研究了人口统计学特征、就诊时的分期、初始治疗情况以及复发率。

方法

从1993年8月至2003年1月期间通过波多黎各大学医学院耳鼻喉科头颈癌诊所确诊的445例组织学确诊的HNSCC病例中获取相关数据。在获得知情同意后收集的数据包括人口统计学因素（性别、年龄、居住地区、收入）；危险因素（职业、酒精摄入量、吸烟情况）；以及病理变量（肿瘤位置、组织病理学、就诊时分期、当前疾病状态、肿瘤复发）。

结果

诊断时的平均年龄为64.0岁（范围18 - 98岁）；84.5%的患者为男性，16%为女性。原发肿瘤最常见的解剖部位是喉（36.4%）和口腔（29.9%）。大多数患者（61.1%）在诊断时处于晚期（III - IV期）疾病，超过一半（55.5%）患有中度分化肿瘤。大多数患者接受正规教育的年限少于12年（81.2%）。分别在88.1%和79.8%的患者中发现长期吸烟和饮酒。最常用的治疗方式是放射治疗，其次是放疗与手术联合。25%的病例在随访期间出现疾病复发。