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2型糖尿病对接受手术和放射治疗的原发性牙龈癌患者预后影响的初步比较研究。

A preliminary comparative study of the prognostic implications of type 2 diabetes mellitus for patients with primary gingival carcinoma treated with surgery and radiation therapy.

作者信息

Ujpál Márta, Barabás József, Kovalszky Ilona, Szabó György, Németh Zsolt, Gábris Katalin, Suba Zsuzsanna

机构信息

Department of Oral and Maxillofacial Surgery, Semmelweis University, Budapest, Hungary.

出版信息

J Oral Maxillofac Surg. 2007 Mar;65(3):452-6. doi: 10.1016/j.joms.2006.09.015.

Abstract

PURPOSE

Type 2 diabetes mellitus (DM2) may be a risk factor in determining cancer progression. The aim of this study was to compare the progression of primary gingival cancer in patients with DM2 and nondiabetic patients.

PATIENTS AND METHODS

Prospective follow-up studies involved patients with gingival squamous cell carcinoma in stage T2-3N0M0. Treatment comprised surgical tumor extirpation, block resection of the mandible, functional cervical dissection, and 60 Gy of adjuvant irradiation. The patients were divided into a group of patients with DM2 (DM group) and a nondiabetic, control group. Progression data was recorded after a 2-year period of clinical follow-up. Surgical samples were assessed histopathologically from the aspect of tumor spread.

RESULTS

At the end of a 2-year follow-up period, the DM group demonstrated significantly worse clinical results in terms of cervical lymph node metastases (P<.05) and mortality rate (P<.001). Histologically, the degree of tumor invasion was significantly different in the DM group and controls (P<.01).

CONCLUSION

DM2 can be considered a possible prognostic factor in cases of gingival carcinoma, forecasting an unfavorable course.

摘要

目的

2型糖尿病(DM2)可能是决定癌症进展的一个风险因素。本研究的目的是比较DM2患者和非糖尿病患者原发性牙龈癌的进展情况。

患者与方法

前瞻性随访研究纳入了T2-3N0M0期牙龈鳞状细胞癌患者。治疗包括手术切除肿瘤、下颌骨整块切除、功能性颈清扫以及60 Gy的辅助放疗。患者被分为DM2患者组(DM组)和非糖尿病对照组。经过2年的临床随访后记录进展数据。从肿瘤扩散方面对手术样本进行组织病理学评估。

结果

在2年随访期结束时,DM组在颈部淋巴结转移(P<0.05)和死亡率(P<0.001)方面的临床结果明显更差。组织学上,DM组和对照组的肿瘤浸润程度有显著差异(P<0.01)。

结论

DM2可被视为牙龈癌病例中一个可能的预后因素,预示着不良病程。

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