Martin-Granizo R, Rodriguez-Campo F, Naval L, Diaz Gonzalez F J
Department of Maxillofacial-Head and Neck Surgery, University Hospital de la Princesa School of Medicine, Autonoma University of Madrid, Spain.
Otolaryngol Head Neck Surg. 1997 Sep;117(3 Pt 1):268-75. doi: 10.1016/s0194-5998(97)70185-2.
Squamous cell carcinoma of the head and neck has been regarded as a disease affecting the elderly. Several etiologic factors have been demonstrated, such as tobacco and alcohol use and premalignant lesions, whereas others have been suspected, such as genetic or immunodeficiency disorders. Recently, some reports have addressed a tendency toward an increase in the incidence of squamous cell carcinoma in young patients. In recent years we have observed an increase in the number of squamous cell carcinomas in patients younger than 40 years. Therefore we retrospectively reviewed our clinical experience of cancer in those patients younger than 40 years. After screening 505 clinical charts, 294 patients met the criteria to enter our study. Twenty-four (8.2%) patients were aged 40 years or younger. Data collected included the history of premalignant lesions, etiologic factors, TNM stages, treatment modalities, and histopathologic issues. Statistical analysis with Kaplan-Meier survival rates and log-rank tests between various variables were applied. A significant association in survival was observed between patterns of recurrence (p = 0.031) and presence of neoplastic cells 5 mm or closer to the specimen margin. On the other hand, a lack of association was assessed in carcinogenic-related habits and in premalignant lesions. Likewise, although men showed a slightly worse prognosis than women, statistically no significant differences were found (p = 0.27).
头颈部鳞状细胞癌一直被视为一种影响老年人的疾病。已经证实了多种病因，如吸烟、饮酒和癌前病变，而其他一些因素，如遗传或免疫缺陷疾病，则受到怀疑。最近，一些报告指出年轻患者中鳞状细胞癌的发病率有上升趋势。近年来，我们观察到40岁以下患者的鳞状细胞癌数量有所增加。因此，我们回顾性地分析了我们在这些40岁以下患者中治疗癌症的临床经验。在筛查了505份临床病历后，有294名患者符合进入我们研究的标准。其中24名（8.2%）患者年龄在40岁及以下。收集的数据包括癌前病变史、病因、TNM分期、治疗方式和组织病理学问题。应用Kaplan-Meier生存率和各变量之间的对数秩检验进行统计分析。在复发模式（p = 0.031）与肿瘤细胞距标本边缘5毫米或更近之间观察到生存存在显著关联。另一方面，在致癌相关习惯和癌前病变方面未评估到关联。同样，尽管男性的预后略比女性差，但在统计学上未发现显著差异（p = 0.27）。
