淋巴結比率與口腔鱗狀細胞癌預後之關聯性－八年回溯性研究

The Correlation Between the Lymph Node Ratio and the Prognosis of Oral Squamous Cell Carcinoma-An Eight-Year Retrospective Study

林若昀(Jo-Yun Lin)；顏欽堉(Ching-Yu Yen)；何宗翰(Chung-Han Ho)；林哲毅(Che-Yi Lin)

口腔鱗狀細胞癌 ； 淋巴結比率 ； Oral squamous cell carcinoma ； Lymph node ratio

臺灣口腔顎面外科學會雜誌

35卷3期（2024 / 09 / 01）

175 - 184

繁體中文;英文

目的：口腔鱗狀細胞癌為口腔最常見的惡性腫瘤，其預後受許多因素影響，包含腫瘤的特性、病患的病況、治療的選擇等，治療方式除了手術之外，是否搭配其他輔助治療，多年來學者們致力研究各項指標，以制定分期和治療的依據來改善預後，而至今，有許多文獻推崇以淋巴結比率做為預後指標，但確切的值卻沒有共識，本次研究參考過去的文獻，分析淋巴結比率0.04是否適用在預測本機構患者的預後。方法：本研究蒐集奇美醫學中心，西元2010至2017年的單一新診斷口腔癌患者，以淋巴結比率為0.04做為分界點來比較患者的預後。結果：淋巴結比率大於或等於0.04的組別，相較於小於0.04組別，在校正潛在風險因子後，五年內的死亡風險比為3.00（95% C.I.: 2.12-4.24）；五年內的疾病復發或死亡風險比為2.54（95% C.I.: 1.84-3.51），具有統計上的顯著差異（p<0.0001）。結論：淋巴結比率設定為0.04，可以作為本機構預後的輔助指標，然而因各機構之間存在人為因素差異，目前各文獻的結果尚未有定論，因此有賴未來更大型且多機構的研究來尋找更準確的值。

Oral squamous cell carcinoma is the most common malignant tumor in the oral cavity. The prognosis is influenced by various factors, including the characteristics of the tumor, the patient's general health condition, and the chosen treatment options. Despite the importance of surgical management, other adjuvant treatments also play a significant role. For many years, scholars have been studying various indicators to establish staging and treatment guidelines to improve prognosis. To date, many articles have recommended the lymph node ratio as a prognostic indicator; however, there is no consensus on its exact value. This study refers to previous literature to analyze whether the lymph node ratio is suitable for predicting the prognosis of patients in our institution. Data from newly diagnosed oral cancer patients at Chi Mei Medical Center between 2010 and 2017 were collected. The lymph node ratio of 0.04 was used as the cut-off point to compare patient prognoses. After adjusting for potential risk factors, the results showed that patients with a lymph node ratio greater than or equal to 0.04 had a hazard ratio of 3.00 (95% C.I.: 2.12-4.24) for mortality within five years compared to those with a ratio less than 0.04. Additionally, the hazard ratio for disease recurrence or mortality within five years was 2.54 (95% C.I.: 1.84-3.51), both with statistically significant differences (p < 0.0001). Therefore, a lymph node ratio of 0.04 could be used as a supplementary prognostic indicator in our institution. However, due to variability in clinical practice and differences among institutions, the results in the literature remain inconclusive. Thus, larger and multi-institutional studies are needed in the future to find a more accurate value.