cN0上颌恶性肿瘤颈淋巴结转移的临床分析

发布时间：2018-04-16 12:32

本文选题：淋巴结 + 上颌骨肿瘤　；参考：《北京大学学报(医学版)》2017年06期

【摘要】：目的:探讨和比较不同病理类型临床颈淋巴结阴性(clinically negative neck lymph node,c N0)上颌恶性肿瘤的颈淋巴结转移率,为此类患者颈部淋巴结的处理提供参考。方法:选择1990年至2010年就诊于北京大学口腔医院具有完整临床及随访资料的c N0上颌恶性肿瘤患者277例,记录颈淋巴结转移情况及相关临床信息,研究不同病理类型上颌恶性肿瘤颈淋巴结转移的发生规律,并通过SPSS 19.0统计学软件分析影响上颈恶性肿瘤淋巴结转移的相关因素。结果:277例c N0上颌恶性肿瘤患者的总体颈淋巴结转移发生率为15.5%(43/277),上颌鳞状细胞癌因其较强的淋巴结转移倾向,颈淋巴结转移率为33.0%;腺源性癌的整体转移率较低,为7.6%,且发生颈淋巴结转移的时间较晚,但高度恶性腺源性癌的淋巴结转移率明显高于中、低度恶性腺源性癌(分别为P=0.037),其中非特异性腺癌、低分化黏液表皮样癌、导管癌的颈淋巴结转移率高于15%,而同属于高度恶性肿瘤的腺样囊性癌与肌上皮癌的转移率较低;肉瘤类恶性肿瘤的整体淋巴结转移率很低,仅为4.9%。结论:建议对c N0上颌鳞状细胞癌患者行选择性颈淋巴结清扫术,对于非特异性腺癌、低分化黏液表皮样癌、导管癌等高度恶性腺源性癌患者可行选择性颈淋巴结清扫术,对于肉瘤类患者可对颈部进行密切观察。
[Abstract]:Objective: to investigate and compare the cervical lymph node metastasis rate of maxillary malignant tumors in clinically negative neck lymph nodec N0 in different pathological types, and to provide a reference for the management of cervical lymph nodes in these patients.Methods: 277 cases of c N0 maxillary malignant tumor with complete clinical and follow-up data from 1990 to 2010 were selected to record the status of cervical lymph node metastasis and related clinical information.To study the regularity of cervical lymph node metastasis in maxillary malignant tumors and analyze the related factors of lymph node metastasis by SPSS 19.0 software.Results the overall incidence of cervical lymph node metastasis in 277 patients with c N0 maxillary malignant tumor was 15.543 / 2770.The cervical lymph node metastasis rate of maxillary squamous cell carcinoma was 33.0 because of its strong lymph node metastasis, and the overall metastasis rate of adenogenic carcinoma was lower.The lymph node metastasis rate of highly malignant adenogenic carcinoma was significantly higher than that of middle and low grade malignant adenogenic carcinoma (P < 0.037, respectively), including non-specific adenocarcinoma and poorly differentiated mucoepidermoid carcinoma.The cervical lymph node metastasis rate of ductal carcinoma was higher than that of 15 tumors, while that of adenoid cystic carcinoma and myoepithelial carcinoma, which were both highly malignant tumors, was lower, while the overall lymph node metastasis rate of sarcomatoid malignant tumors was very low, which was only 4.9.Conclusion: selective neck lymph node dissection is recommended for patients with c N0 maxillary squamous cell carcinoma, and can be used for non-specific adenocarcinoma, poorly differentiated mucoepidermoid carcinoma, ductal carcinoma and other highly malignant adenogenic carcinomas.For sarcomatous patients, the neck can be closely observed.
【作者单位】：北京大学口腔医学院·口腔医院口腔颌面外科口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室;北京大学口腔医学院·口腔医院第二门诊部口腔颌面外科口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室;
【基金】：国家科技支撑计划项目(2014BAI04B06)资助~~
【分类号】：R739.8

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