【摘要】 目的通过分析唾液腺腺样囊性癌(SACC)患者的病历资料,建立生存预测模型,并探讨其临床应用价值。方法分析118例有完整随访资料的SACC患者的病历资料,选择10个可能对患者预后产生影响的临床病理因素,通过Cox模型进行多因素分析,建立预后指数方程。然后根据预后指数(PI)将患者分为高、中、低危险3个组,应用Kaplan Meier法绘制3个组的生存曲线,得到各组总的累积生存率及中位生存时间。结果Cox模型多因素分析显示:SACC确诊时的年龄、临床症状、TNM临床分期、治疗方式、手术切缘与总累积生存率有关(P<0.05)。预后指数方程为PI=0.031X2+0.665X5+0.420X6-0.576X7+0.999X10。根据预后指数分为低危险组(PI<3.57)、中危险组(PI=3.57～4.50)、高危险组(PI>4.50),预后指数越小,患者预后越好。3组的中位生存时间分别为18年、7年和4年,10年总累积生存率分别为83.56%、31.45%和11.20%。结论生存预测模型能够较全面反映SACC患者的预后,可预测不同患者的生存率,为临床治疗提供参考。更多还原

【Abstract】 Objective To establish a predicting model of survival rates and to evaluate the weighted contributions of each key prognostic factor of the patients with salivary adenoid cystic carcinoma（SACC）.Methods One hundred and eighteen follow-up cases with SACC were analyzed for the survival study with retrospective cohort method. Ten possible clinical and pathologic factors were selected. A multivariate analysis was performed by Cox proportional hazard model and prognostic index （PI） was calculated. According to the PI, all cases were divided into three risk subgroups respectively: lower,intermediate and higher risk subgroups. Ten-year survival rate and median survival time were calculated and the predicting models of survival rates were established. Results The significant prognostic factors influencing the survival rate were age at diagnosis, clinical presentation, TNM clinical stage, treatment, surgical margins （P<0.05）.The predicting formula was PI=0.031X₂+0.665X₅+0.420X₆-0.576X₇+0.999X 10. According to the value of PI, the prognosis of the patients was significantly different among the three subgroups （P<0.05）. In the three risk subgroups, 10-year survival rates were 83.56%, 31.45% and 11.20% respectively, the median survival time was 18 years, 7 years and 4 years respectively.Conclusions The established predicting model of survival rates can predict the prognosis of the patients with SACC.更多还原