Nabukenya Jamilah, Hadlock Tessa A, Arubaku Wilfred
Ear, Nose and Throat Department, Mbarara University of Science and Technology, Mbarara, Uganda.
Massecheutts Ear and Eye Infirmary, Boston, Massachusetts, USA.
OTO Open. 2018 Mar 16;2(1):2473974X18761868. doi: 10.1177/2473974X18761868. eCollection 2018 Jan-Mar.
Patients with head and neck squamous cell carcinoma (HNSCC) have symptoms that masquerade as benign conditions, resulting in late presentations. The objective is to describe characteristics and stages of patients with HNSCC and document their prognosis from clinical experience in western Uganda.
Cross-sectional study with clinical follow-up.
Mbarara Regional Referral Hospital.
Fifty-one participants were recruited from February to July 2016. A questionnaire was used for patient characteristics, and staging, serologic studies, biopsy for histopathology, and immunohistochemistry were investigated. Staging was subclassified as early (stage I and II) and late (stage III and IV). Analysis was done with Fisher's exact test.
Of 51 participants, 44 (86.5%) were male; the group had a mean age of 57.7 years, and 41 (80.1%) presented with late stage. Of 10 participants who presented with early stage, 6 (60%) had laryngeal HNSCC. The pharynx was ranked as the highest subsite (n = 19, 37.3%), followed by the oral cavity (n = 9, 17.6%), the larynx (n = 9, 17.6%), an unknown primary (n = 8, 15.7%), and sinonasal area (n = 6, 11.8%). Tobacco smoking, alcohol consumption, and prior use of traditional remedy were common characteristics among participants. Moderate differentiation was the most common grade (n = 23, 45.1%). , Epstein-Barr virus, human immunodeficiency virus, and human papilloma virus type 16 were identified among 51 participants. However, none could afford referral for radiotherapy; hence, 1-year survival was 4%.
The majority of our patients with HNSCC present at late stage, and the prognosis is poor. There is great need for preventative community-based education and early screening services to save our population.
头颈部鳞状细胞癌（HNSCC）患者的症状常被误诊为良性疾病，导致就诊延迟。目的是描述乌干达西部HNSCC患者的特征和分期，并根据临床经验记录其预后情况。
采用临床随访的横断面研究。
姆巴拉拉地区转诊医院。
2016年2月至7月招募了51名参与者。使用问卷收集患者特征，并进行分期、血清学研究、组织病理学活检和免疫组织化学检测。分期分为早期（I期和II期）和晚期（III期和IV期）。采用Fisher精确检验进行分析。
51名参与者中，44名（86.5%）为男性；该组平均年龄为57.7岁，41名（80.1%）为晚期就诊。10名早期就诊的参与者中，6名（60%）患有喉HNSCC。咽被列为最常见的亚部位（n = 19，37.3%），其次是口腔（n = 9，17.6%）、喉（n = 9，17.6%）、原发灶不明（n = 8，15.7%）和鼻窦区（n = 6，11.8%）。吸烟、饮酒和既往使用传统疗法是参与者的常见特征。中度分化是最常见的分级（n = 23，45.1%）......在51名参与者中检测到爱泼斯坦 - 巴尔病毒、人类免疫缺陷病毒和16型人乳头瘤病毒。然而，没有人能够负担得起转诊放疗的费用；因此，1年生存率为4%。
我们的大多数HNSCC患者就诊时已处于晚期，预后较差。非常需要开展基于社区的预防教育和早期筛查服务以挽救我们的人群。
