临床N0期舌癌颈淋巴结转移相关因素及其外科处理

发布时间：2018-04-14 07:47

  本文选题：舌癌 + 颈淋巴结转移　； 参考：《肿瘤防治研究》2014年07期

【摘要】：目的探讨舌癌隐匿性颈淋巴结转移规律和相关影响因素,以及不同颈淋巴清扫术式对舌癌的预后影响,为cN0期舌癌患者颈淋巴清扫术术式的选择提供理论依据。方法收集2002年1月至2010年8月在广西医科大学附属肿瘤医院头颈外科初治的cN0期舌癌住院患者87例。通过单因素分析隐匿性颈淋巴结转移与年龄、性别、术前疾病持续时间、原发灶浸润深度、T分期、病理分级的相关性,多因素分析cN0期舌癌患者的预后影响因素,探讨舌鳞癌颈部转移规律及外科处理方式。结果单因素统计分析显示:性别、年龄、术前疾病持续时间对cN0期舌癌患者隐匿性颈淋巴结转移的影响差异无统计学意义(P0.05),而原发灶浸润深度、T分期、病理分级等因素对颈淋巴结转移的影响差异有统计学意义(P0.05)。多因素Cox风险比例模型分析显示:只有T分期是舌癌cN0期患者的独立预后因素,不同颈淋巴清扫术对其预后的影响差异无统计学意义。颈择区性淋巴清扫术对肩部的影响更小(P0.05)。结论原发灶浸润深度、T分期、病理分级与cN0期舌癌隐匿性颈淋巴结转移有关,可以作为预测cN0期舌癌隐匿性颈淋巴结转移的指标;cN0期舌癌具有较高的隐匿性颈部淋巴结转移率,以同侧颈部Ⅰ、Ⅱ、Ⅲ区最为常见,主张行颈择区淋巴清扫术。
[Abstract]:Objective to investigate the law of occult cervical lymph node metastasis in tongue cancer and the influence of different neck dissection on the prognosis of tongue cancer, and to provide a theoretical basis for the choice of cervical lymph node dissection in patients with cN0's carcinoma of tongue.Methods from January 2002 to August 2010, 87 patients with cN0 stage tongue cancer were treated in head and neck surgery, affiliated Cancer Hospital of Guangxi Medical University.By univariate analysis of the correlation between occult cervical lymph node metastasis and age, sex, duration of disease before operation, depth of invasion of primary tumor and T stage, pathological grade, multivariate analysis of prognostic factors in cN0 patients with tongue cancer.To investigate the law of cervical metastasis and surgical management of tongue squamous cell carcinoma.Results the univariate statistical analysis showed that there was no significant difference in the influence of sex, age and preoperative disease duration on the occult cervical lymph node metastasis in patients with cN0 stage tongue cancer.The influence of pathological grade on cervical lymph node metastasis was significantly different (P 0.05).Multivariate Cox risk ratio model analysis showed that only T stage was an independent prognostic factor in patients with cN0 stage of tongue cancer. There was no significant difference in the influence of different neck dissection on the prognosis of patients with tongue cancer.The effect of cervical lymph node dissection on shoulder was smaller than that of P0.05.Conclusion T stage and pathological grade of primary tumor invasion are related to occult cervical lymph node metastasis of tongue carcinoma in cN0 stage, which can be used as a predictor of occult cervical lymph node metastasis in cN0 stage tongue cancer.The ipsilateral neck regions 鈪，

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