摘要目的 分析头颈鳞癌患者脑转移的临床特征,探讨头颈鳞癌脑转移相关的危险因素.方法 利用SEER* Stat软件搜索美国国立癌症研究所的监测、流行病学和结果(SEER)数据库,筛选2010-2015年18岁以上经病理确诊的头颈鳞癌患者,获得头颈鳞癌在诊断时脑转移的发生率以及脑转移患者的生存数据,用Kaplan-Meier法计算生存率,Logistic单因素和多因素分析年龄、性别、肿瘤原发部位、T分期、N分期等因素与脑转移的相关性.结果 SEER数据库筛选得到头颈鳞癌患者60 410例,其中男性45 745,女性14 665例,中位年龄63岁(18～110岁).远处转移患者2 245例(3.72％),脑转移患者80例(3.56％).脑转移患者的中位生存时间3个月(0～61个月),1年、2年、3年生存率分别为17.6％、10.6％和3.5％.与脑转移相关的危险因素为肿瘤原发部位、组织学分级和T分期(P值均＜0.01).结论 头颈肿瘤患者脑转移的发生率低,预后差,脑转移者生存期短.原发灶分析,鼻咽部脑转移率最高,口咽和口腔次之,喉部最少发生脑转移.肿瘤分化越差、T分期越晚,脑转移发生风险越高.

abstractsObjective To investigate clinical characteristics and risk factors of brain metastasis in patients with head and neck squamous cell carcinoma (HNSCC).Methods From 2010 to 2015,patients over 18 years of age,with pathologically confirmed HNSCC at the time of diagnosis,were identified using SEER database of the National Cancer Institute.Incidence of brain metastasis and survival data of the patients were calculated.Kaplan-Meier method was used to calculate survival rate.Logistic univariate and multivariate analysis was used to analyze the correlations between age,sex,T stage,N stage and brain metastasis.Results We identified 60410 patients with HNSCC,45745 were males and 14665 were females,with a median age of 63 years old (18-110 years old).2245(3.72％) had distant metastasis and 80 (3.56％) had brain metastasis.The median survival time of patients with brain metastasis was 3 months (0-61 months).The 1-year,2-year and 3-year survival rates were 17.6％,10.6％ and 3.5％,respectively.The risk factors associated with brain metastasis were primary tumor site,histological grade and T stage.Conclusions The incidence of brain metastasis in patients with HNSCC is low,but the prognosis is poor.Once brain metastasis occurs,survival time of the patients is short.The highest rate of brain metastasis was found in nasopharynx,followed by oropharynx and oral cavity,and the least in larynx.In addition,the poorer differentiation of the tumors,and the later T stage,the higher risk of brain metastasis.