臺灣博碩士論文加值系統

口腔癌是台灣惡性腫瘤死因之第五名，尤其在男性惡性腫瘤死因中更是高達第四名。口腔癌主要好發於中年男性，是國人男性50～54歲發生率最高的癌症。而口腔癌中又以鱗狀細胞癌所佔最多，故本研究以口腔鱗狀細胞癌 （Oral cavity squamous cell carcinoma） 為風險評估重點。本研究為回溯型研究，使用資料為北部某醫學中心的手術後病理報告資料，評估口腔鱗狀細胞癌病患第二原發性腫瘤的風險。研究結果發現，自2001年1月1日至2008年12月31日自病理報告資料庫中篩選出之口腔癌病患共950位（n=950），口腔鱗狀細胞癌 （OSCC） 病患而後又罹患第二原發性腫瘤（SPTs）亦為口腔鱗狀細胞癌共57位，病患於第一次術後之病理報告資料統計結果顯示，OSCC罹患SPTs之病患仍以男性佔大多數（男:女=56:1），且年紀皆介於40至49歲（n=27，47%），分化程度則多為中度分化（n=30，53%）和高度分化（n=24，42%），侵犯深度多集中於1mm至10mm（n=32，56%）。腫瘤是否侵襲神經周圍（perineural invasion）對口腔癌病患是否罹患第二原發腫瘤具有顯著性影響（p<0.05）。

Oral cancer is a malignant carcinoma incident in Taiwan, especially in male. It ranked the 5th place in cause of death of malignant carcinoma in Taiwan generally and the 4th place in male patients. Therefore, the research for oral cancer is become more and more important nowadays.

This is a retrospective cohort study by using the data from pathological report from anatomic pathology department in a medical center in Taiwan and conduct the method of data mining to make a risk assessment of second primary tumor of oral cavity squamous cell carcinoma. There are 950 OSCC patients are enrolled in this study, 893 OSCC patients without SPT, 57 OSCC patients developed SPTs also diagnosed as squamous cell carcinoma. The result showed that the age of OSCC patients developed SPTs almost at 40-49 years old, and more than 90% of OSCC patients with SPTs were male, the status of differentiation mostly were moderate and well differentiation, and the depth of invasion mostly concentrated in 1mm to 10mm. The factor of perineural invasion was significant (p<0.05) for SPT in our data.

標題 i
審定書 ii
致謝 vi
Chinese Abstract viii
English Abstract ix
Table of Contents x
List of Tables xiii
List of Figures xiv
Chapter 1 Introduction 1
1.1 Background 1
1.2 Motivation and Goals 2
Chapter 2 Literature Review 4
2.1 Oral Cancer 4
2.1.1 Introduction 4
2.1.2 Epidemiology 4
2.1.3 Diagnosis and staging 6
2.2 Prognostic factor of oral cavity cancer 8
2.3 Second primary tumor of oral cavity cancer 10
2.3.1 Definition 10
2.4 Data mining 10
2.4.1 Introduction 10
Chapter 3 Materials and Methods 11
3.1 Study Design 11
3.1.1 Data Collection 11
3.1.2 Data Processing 11
3.2 Statistical Analysis 14
3.3 Statistical Tool 14
3.4 Analyzable variables 14
Chapter 4 Results 16
4.1 Distribution of Patients with Oral cavity squamous cell carcinoma 16
4.1.1 Gender distribution of OSCC 16
4.1.2 Characteristics of Age Groups 17
4.1.3 Tumor sites of Oral cavity squamous cell carcinoma 18
4.1.4 Differentiation of OSCC patients 18
4.1.5 Depth of tumor invasion 19
4.1.6 Depth of tumor invasion grouped by 10 mm 19
4.2 Distribution of OSCC patients with second primary tumor 20
4.2.1 SPTs rate during 2001 and 2008 20
4.2.2 Age of OSCC patients with SPTs 20
4.2.3 Tumor sites of OSCC patients without and with SPTs 21
4.2.4 Differentiation of OSCC patients without and with SPTs 22
4.2.5 Depth of tumor invasion of OSCC patients with SPTs 23
4.2.6 Depth of tumor invasion of OSCC patients with SPTs grouped by 10 mm 23
4.3 Characteristics of OSCC patients with comparison of non-SPTs and SPTs 23
4.3.1 Age 24
4.3.2 Sex 24
4.3.3 Depth of invasion 24
4.3.4 Differentiation 24
4.3.5 Site of tumor 25
4.3.6 Depth of invasion group 25
4.3.7 Age group 25
4.3.8 Perineural invasion 25
4.3.9 Lymphatic invasion and lymph node metastasis 26
4.4 Survival Analysis 29
4.5 Nomogram predictive model for 6-year and 7-year SPT-free probability 30
Chapter 5 Discussion 33
5.1 Comparison of related studies 33
5.2 Limitation 33
5.2.1 Data ranged within limits 33
5.2.2 Insufficient clinical information 34
Chapter 6 Conclusion 35
References 36

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