本文選題：喉鱗狀細(xì)胞癌 + NLR��； 參考：《鄭州大學(xué)》2016年碩士論文

【摘要】：目的喉癌是頭頸部常見的惡性腫瘤。目前,由于環(huán)境污染的日益加重及吸煙飲酒人數(shù)的不斷增多,其發(fā)病率也在隨之升高。盡管醫(yī)療條件及醫(yī)學(xué)技術(shù)較前大幅提高,但喉癌患者的生存率及生存質(zhì)量較前卻無明顯改善。本文旨在分析影響喉癌患者預(yù)后的相關(guān)因素,為提高喉癌患者的生存率及生存質(zhì)量提供依據(jù)。方法應(yīng)用回顧性隊(duì)列研究的方法分析了于2010年1月至2012年12月期間在鄭州大學(xué)人民醫(yī)院(河南省人民醫(yī)院)收治的117例喉癌患者完整的臨床資料,對可能影響喉癌患者預(yù)后的多項(xiàng)臨床指標(biāo),如患者的性別、年齡、吸煙量、飲酒量、合并癥情況、術(shù)前中性粒細(xì)胞與淋巴細(xì)胞的比值(NLR)、臨床分型、喉癌分型、T分期、N分期、腫瘤的分化程度、手術(shù)方式、頸部淋巴結(jié)清掃情況、切緣情況、治療方案等因素進(jìn)行了嚴(yán)密的檢測及記錄。使用SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,運(yùn)用Kaplan-Meier法進(jìn)行單因素生存分析,Log-rank進(jìn)行檢驗(yàn),并建立Cox比例風(fēng)險(xiǎn)回歸模型對患者預(yù)后進(jìn)行多因素分析。均以P0.05具有統(tǒng)計(jì)學(xué)意義。結(jié)果本組喉癌患者共計(jì)117例,截止至隨訪結(jié)束日期,92例存活,25例死亡。隨訪時間均超過36個月。本組喉癌患者1年總生存率(OS)為84%,3年總生存率(OS)為81%,5年總生存率(OS)為70%。其中Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期喉癌患者的3年總生存率(OS)分別為87%、82%、70%和62%,5年總生存率(OS)分別為75%、77%、70%和62%。運(yùn)用Kaplan-Meier法對可能影響喉癌患者預(yù)后的諸多因素進(jìn)行單因素生存分析,結(jié)果提示患者因素中的年齡、吸煙包年量、NLR和腫瘤因素中的病理分化程度、喉癌分型、TN分期、臨床分型均是影響喉癌預(yù)后的相關(guān)因素;建立Cox比例風(fēng)險(xiǎn)回歸模型對相關(guān)指標(biāo)進(jìn)行多因素分析,結(jié)果顯示腫瘤的病理分化程度及N分期是影響喉癌患者預(yù)后的獨(dú)立危險(xiǎn)因素。結(jié)論倡導(dǎo)健康的生活習(xí)慣,根據(jù)喉癌患者的自身情況及腫瘤的TNM分期給予及時、正確的診治,選擇恰當(dāng)?shù)闹委煼桨笍氐兹コ[瘤,正確處理頸部淋巴結(jié),從而為患者預(yù)后提供保障。
[Abstract]:Objective laryngeal carcinoma is a common malignant tumor in head and neck. At present, due to the increasing environmental pollution and the increasing number of smoking and drinking, the incidence of the disease is also increasing. The survival rate and quality of life of laryngeal cancer patients were not significantly improved, although the medical conditions and medical techniques were significantly improved. The purpose of this paper is to analyze the factors influencing the prognosis of patients with laryngeal carcinoma, and to provide evidence for improving the survival rate and quality of life of patients with laryngeal carcinoma. Methods A retrospective cohort study was used to analyze the complete clinical data of 117 patients with laryngeal cancer admitted to the people's Hospital of Zhengzhou University (Henan people's Hospital) from January 2010 to December 2012. The clinical parameters that may affect the prognosis of laryngeal cancer patients, such as sex, age, smoking, alcohol consumption, complications, the ratio of neutrophils to lymphocytes before operation, clinical classification, T stage and N stage of laryngeal carcinoma, were analyzed. The degree of differentiation, operation, neck lymph node dissection, incisal margin, treatment plan and other factors were closely examined and recorded. SPSS 17.0 software was used for statistical analysis, Kaplan-Meier method was used for univariate survival analysis and Log-rank test, and Cox proportional risk regression model was established for multivariate analysis of prognosis. All had statistical significance with P0.05. Results there were 117 patients with laryngeal carcinoma and 25 patients died by the end of follow-up. All patients were followed up for more than 36 months. The 1-year overall survival rate was 84%, the 3-year overall survival rate was 81%, and the 5-year overall survival rate was 70%. The 3-year overall survival rate of patients with stage 鈪，

本文編號：1932134