早期口腔舌鳞状细胞癌：相关因素和患者预后。
Early onset oral tongue squamous cell carcinoma: Associated factors and patient outcomes.
机构信息
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Vanderbilt University, Nashville, Tennessee, USA.
出版信息
Head Neck. 2019 Jun;41(6):1952-1960. doi: 10.1002/hed.25650. Epub 2019 Jan 11.
BACKGROUND
Incidence of oral tongue squamous cell carcinoma (OTC) is rising among those under age 50 years. The etiology is unknown.
METHODS
A total of 395 cases of OTC diagnosed and/or treated at Vanderbilt University Medical Center between 2000 and 2017 were identified. Of those, 113 (28.6%) were early onset (age < 50 years). Logistic regression was used to identify factors associated with early onset OTC. Cox proportional hazards models evaluated survival and recurrence.
RESULTS
Compared to typical onset patients, patients with early onset OTC were more likely to receive multimodality treatment (surgery and radiation; adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI], 1.2-6.3) and report a history of snuff use (aOR, 5.4; 95% CI, 1.8-15.8) and were less likely to report a history of cigarette use (aOR, 0.5; 95% CI, 0.2-0.9). Early onset patients had better overall survival (adjusted hazard ratio, 0.6).
CONCLUSIONS
This is the largest study to evaluate factors associated with early onset OTC and the first to report an association with snuff.
背景
50 岁以下人群中口腔舌鳞状细胞癌（OTS）的发病率正在上升。病因不明。
方法
共确定了 2000 年至 2017 年间在范德比尔特大学医学中心诊断和/或治疗的 395 例 OTS 病例。其中，113 例（28.6%）为早期发病（年龄<50 岁）。使用逻辑回归确定与早期 OTS 发病相关的因素。Cox 比例风险模型评估生存和复发情况。
结果
与典型发病患者相比，早期发病 OTS 患者更有可能接受多模式治疗（手术和放疗；调整后的优势比 [aOR]，2.7；95%置信区间 [CI]，1.2-6.3），更有可能报告吸食鼻烟史（aOR，5.4；95%CI，1.8-15.8），更不可能报告吸烟史（aOR，0.5；95%CI，0.2-0.9）。早期发病患者的总体生存率更好（调整后的危险比，0.6）。
结论
这是评估与早期 OTS 发病相关因素的最大研究，也是第一个报告与鼻烟有关的研究。
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