术前糖化血红蛋白水平对口腔鳞状细胞癌结局的影响。

The impact of preoperative glycated hemoglobin levels on outcomes in oral squamous cell carcinoma.

机构信息

Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Department of Otolaryngology, Sengkang General Hospital, Singapore, Singapore.

出版信息

Oral Dis. 2020 Oct;26(7):1449-1458. doi: 10.1111/odi.13433. Epub 2020 Jun 16.

DOI:10.1111/odi.13433

PMID:32426892

Abstract

OBJECTIVES

This study aimed to investigate the association between preoperative glycated hemoglobin (HbA1c) levels and the treatment outcomes of oral cavity squamous cell carcinoma (OSCC).

METHODS

Three hundred and fifty-eight OSCC patients were consecutively enrolled between July 2004 and July 2016. Clinicopathological parameters and survival outcomes were analyzed following HbA1c stratification of 6.5% (HbA1c ≥ 6.5%: n = 74, 20.6%) and 7.0% (HbA1c ≥ 7.0%: n = 53, 14.8%).

RESULTS

Higher HbA1c levels were associated with elevated body mass index, lower albumin levels, wider surgical margins, and prolonged hospital stays (HbA1c 6.5%: p = .001, .048, .030, .009, respectively; HbA1c 7.0%: p = .092, .032, .009, .015, respectively). Survival rates stratified by HbA1c 6.5% were as follows: locoregional recurrence-free survival, p = .014; distant metastasis-free survival, p = .013; second primary cancer-free survival, p = .015; overall survival, p = .014; disease-specific survival, p = .002 and HbA1c 7.0%: locoregional recurrence-free survival, p = .013; distant metastasis-free survival, p = .013; second primary cancer-free survival, p = .014; overall survival, p = .015; disease-specific survival, p = .004. Multivariate analyses identified HbA1c as an independent prognostic factor for overall and disease-specific survival (HbA1c 6.5%: p = .014 and .002, respectively; HbA1c 7.0%: p = .036 and .013, respectively).

CONCLUSIONS

Oral squamous cell carcinoma patients with higher preoperative HbA1c levels had longer hospitalization and worse survival outcomes.

摘要

目的

本研究旨在探讨术前糖化血红蛋白（HbA1c）水平与口腔鳞状细胞癌（OSCC）治疗结果之间的关系。

方法

连续纳入 2004 年 7 月至 2016 年 7 月期间的 358 例 OSCC 患者。根据 HbA1c 水平的 6.5%（HbA1c≥6.5%：n=74，20.6%）和 7.0%（HbA1c≥7.0%：n=53，14.8%）进行分层，分析临床病理参数和生存结果。

结果

较高的 HbA1c 水平与升高的体重指数、较低的白蛋白水平、较宽的手术切缘和延长的住院时间相关（HbA1c 6.5%：p=0.001，p=0.048，p=0.030，p=0.009，分别；HbA1c 7.0%：p=0.092，p=0.032，p=0.009，p=0.015，分别）。根据 HbA1c 6.5%分层的生存率如下：局部区域无复发生存率，p=0.014；远处无转移生存率，p=0.013；第二原发癌无生存率，p=0.015；总生存率，p=0.014；疾病特异性生存率，p=0.002；HbA1c 7.0%：局部区域无复发生存率，p=0.013；远处无转移生存率，p=0.013；第二原发癌无生存率，p=0.014；总生存率，p=0.015；疾病特异性生存率，p=0.004。多变量分析确定 HbA1c 是总生存率和疾病特异性生存率的独立预后因素（HbA1c 6.5%：p=0.014 和 p=0.002，分别；HbA1c 7.0%：p=0.036 和 p=0.013，分别）。