Morales-Angulo C, Val-Bernal F, Buelta L, Fernandez F, García-Castrillo L, Rama J
Department of Otolaryngology, Sierrallana Hospital, Torrelavega, Spain.
Otolaryngol Head Neck Surg. 1998 Nov;119(5):548-53. doi: 10.1016/S0194-5998(98)70123-8.
We carried out a retrospective study of patients with supraglottic carcinomas who were treated surgically at the Marques de Valdecilla Hospital (Santander, Spain) between 1978 and 1987 and who were followed up for at least 5 years. The Kaplan-Meier survival curves were calculated for 24 clinical, histologic, and morphometric parameters. Multivariate analysis was then performed by means of the Cox regression model. In the univariate analysis, survival was related to presence of capsule rupture of the involved lymph nodes (p = 0.00001), number of metastatic lymph nodes (p = 0.0002), postoperative TNM stage (p = 0.004), grade of cell differentiation (p = 0.001), presence of intratumoral necrosis (p = 0.01), and type of invasion (p = 0.04). The nuclear area did not have an influence on survival. Only the presence or absence of capsule rupture of the metastatic lymph nodes and the grade of cell differentiation were included in the final Cox model and proved to be parameters with independent prognostic significance.
我们对1978年至1987年间在西班牙桑坦德市瓦尔迪西利亚侯爵医院接受手术治疗且随访至少5年的声门上型癌患者进行了一项回顾性研究。针对24项临床、组织学和形态学参数计算了Kaplan-Meier生存曲线。然后通过Cox回归模型进行多变量分析。在单变量分析中，生存率与受累淋巴结包膜破裂情况（p = 0.00001）、转移性淋巴结数量（p = 0.0002）、术后TNM分期（p = 0.004）、细胞分化程度（p = 0.001）、肿瘤内坏死情况（p = 0.01）以及浸润类型（p = 0.04）相关。核面积对生存率无影响。最终的Cox模型仅纳入了转移性淋巴结包膜破裂的有无及细胞分化程度，结果证明这两个参数具有独立的预后意义。
