淋巴血管侵犯预测喉癌生存：一项国家数据库分析。
Lymphovascular Invasion Predicts Survival in Laryngeal Cancer: A National Database Analysis.
文献信息
| PMID | 42760601 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Felipe Porto-Gutierrez |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 淋巴血管侵犯（LVI）在喉鳞状细胞癌（LSCC）中常规报告，但其独立预后意义和治疗意义仍不确定。我们在一个大型接受手术治疗的LSCC队列中评估了LVI与总生存期（OS）之间的关联。
方法： 纳入接受根治性手术切除且无远处转移的成人LSCC患者。排除术前接受放疗、全身治疗或非鳞状组织学的患者。多变量Cox回归评估LVI与OS之间的关联，并调整人口统计学、合并症、分期、亚部位、手术切缘、机构类型和治疗方式。
结果： 共有10,052例患者符合纳入标准；2037例（20.3%）存在LVI。平均随访时间为70±46个月。LVI与更差的OS独立相关（HR 1.22，95% CI 1.13-1.32，p<0.001），并且在声门型（HR 1.30，p=0.001）和声门上型（HR 1.26，p<0.001）肿瘤中持续存在。里程碑分析显示存在时间变化，LVI在随访超过24个月后仍与更差的OS显著相关（HR 1.18，p=0.001）。在LVI患者中，与单纯手术相比，PORT和POCRT与生存改善相关。
结论： LVI是LSCC中与生存降低相关的不良预后因素，其预后影响随时间变化。将其整合到术后风险评估中可能有助于指导辅助治疗选择和术后分层。
英文摘要
OBJECTIVE: Lymphovascular invasion (LVI) is routinely reported in laryngeal squamous cell carcinoma (LSCC), yet its independent prognostic significance and therapeutic implications remain uncertain. We evaluated the association between LVI and overall survival (OS) in a large cohort of surgically treated LSCC.
METHODS: Adults with LSCC who underwent definitive surgical resection without distant metastases were included. Patients with preoperative radiotherapy, systemic therapy, or non-squamous histology were excluded. Multivariable Cox regression assessed the association between LVI and OS, adjusting for demographics, comorbidity, stage, subsite, surgical margins, facility type, and treatment modality.
RESULTS: A total of 10,052 patients met inclusion criteria; 2037 (20.3%) had LVI. Mean follow-up was 70 ± 46 months. LVI was independently associated with worse OS (HR 1.22, 95% CI 1.13-1.32, p < 0.001), persisting in glottic (HR 1.30, p = 0.001) and supraglottic (HR 1.26, p < 0.001) tumors. Landmark analyses demonstrated temporal variation, with LVI remaining significantly associated with worse OS beyond 24 months of follow-up (HR 1.18, p = 0.001). Among patients with LVI, PORT and POCRT were associated with improved survival compared with surgery alone.
CONCLUSION: LVI is an adverse prognostic factor associated with reduced survival in LSCC, with prognostic impact varying over time. Its integration into postoperative risk assessment may help inform adjuvant therapy selection and postoperative stratification.