Analysis Of Related Influencing Factors Of Tumor Recurrence And Metastasis In Tongue Cancer Patients Using Structural Equation Model

Objective : Based on the medical history data of tongue cancer patients in Hunan Cancer Hospital from 2010 to 2016,through single-factor analysis and construction of a structural equation model,the role of each dominant and potential influencing factor and its effect were analyzed to explore the recurrence of tongue cancer patients And related factors of lymph node metastasis after surgery,provide theoretical basis for the development of targeted intervention strategies.Methods:(1)Retrieving tongue cancer patients hospitalized from January 1,2010 to December 31,2016 in a hospital medical record management system in Hunan Province,using systematic sampling method,a total of 1,000 tongue cancer patient medical records were selected,and 234 tongue cancers were excluded according to the inclusion exclusion criteria Patient medical records,and finally obtained medical records of 766 tongue cancer patients.Through the medical record management system,data related to electronic medical records were extracted.Using Epidata 3.1 software,two data entrants independently entered patient information to establish an electronic medical record analysis database for tongue cancer patients.(2)Describe the basic situation,living habits and clinical characteristics of tongue cancer patients,and perform univariate analysis(or t-test)on tonguepatients with recurrence and postoperative lymph node metastasis.(3)Factor analysis was used to analyze the structure of the collected medical data of tongue cancer patients.(4)Using the structural equation model,from the treatment situation,living habits and basic conditions,to explore the relevant factors affecting tongue cancer patients' recurrence and postoperative lymph node metastasis from multiple levels,and analyze the path of each influencing factor and its effect.Results: This study collected medical records of 766 tongue cancer patients in a hospital in Hunan Province.(1)It is found from the basic information of tongue cancer patients that tongue cancer patients are mostly married middle-aged men,and there are generally bad living habits,including 411 smokers(57.6%),282 people drinking(36.8%),and betel nut 129 patients(16.8%);158 patients with recurrent tongue cancer(158 patients(20.6%);83 patients with postoperative lymph node metastasis(10.8%).(3)The pathological examination of most tongue cancer patients is well-differentiated squamous cell carcinoma,a total of575(75.1%),and the tumors are mostly in the tongue(91.5%).(4)The number of patients with tongue cancer cured after hospitalization was 434(56.7%),and only 13.4% of the patients did not heal.The treatment tendency of the patients was better.The number of operations was 610(73.6%),the number of lymph node dissections was 522(68.1%),and the number of flap operations was 543(70.9%).According to the results of single factor analysis,age,treatment method,flap surgery,preoperative lymph node metastasis,preoperative comorbidities,and healing grade all have an effect on the recurrence of tongue cancer patients.Gender,discharge,treatment,lymph node dissection,flap surgery,preoperative comorbidities,and healing grade all have an impact on the prognosis and recurrence of tongue cancer patients.A structural equation model was established to analyze the influencing factors of tongue cancer patients recurrence and postoperative lymph node metastasis.The specific results of the constructed structural equation model are as follows:(1)The treatment of tongue cancer patients can directly affect the recurrence of patients,the direct effect is-0.110,P<0.05.And it can directly affect the patient's postoperative lymph node metastasis.The direct effect is-0.263,P <0.001.(2)Living habits of tongue cancer patients can indirectly affect the recurrence of patients through lymph node metastasis and treatment,the indirect effect is 0.021,the coefficients of the three paths are P <0.05,and can indirectly affect the operation of patients through lymph node metastasis and treatment After lymph node metastasis,the indirect effect is-0.003,and the coefficients of the three pathways are all P<0.05.(3)Lymph node metastasis in tongue cancer patients can directly affect the recurrence of the patient.The direct effect is 0.175,P<0.001,and can indirectly affect the patient's recurrence by affecting the patient's treatment.0.05,so thetotal effect of the patient's lymph node metastasis on the patients recurrence is 0.164.(4)The location of the tumor can indirectly affect the recurrence of tongue cancer patients through treatment,and the indirect effect is 0.020,P<0.05.In addition,it can indirectly affect patients' lymph node metastasis through treatment.The indirect effect is 0.047,and the coefficients of both paths are P<0.05.Conclusion:(1)The treatment status of tongue cancer patients,that is,treatment method,flap surgery,healing grade,lymph node dissection and discharge can affect the recurrence of patients and the postoperative lymph node metastasis.(2)The lymph node metastasis of patients with tongue cancer before hospitalization can affect the recurrence of the patient,and can further affect the postoperative lymph node metastasis of the patient by affecting the patient's treatment hospital.(3)The tumor site of tongue cancer patients can further affect the patient's recurrence and postoperative lymph node metastasis by affecting the patient's treatment.