cNO口腔鳞状细胞癌颈部淋巴结转移的临床分析

发布时间：2019-04-08 11:47

【摘要】：目的：通过对cN0口腔鳞状细胞癌临床资料的回顾性分析，探讨颈部淋巴结阴性（clinical lymphnode-negative cN0）的口腔鳞癌（oral squamous cell carcinoma, OSCC）患者发生颈淋巴结隐匿性转移的规律和相关影响因素，以确定是否需要行同期颈部淋巴结处理。方法：收集石河子大学第一附属医院2008年7月-2013年7月接受颈淋巴结清扫的85例cN0口腔鳞癌患者的临床和病理资料，回顾性分析颈部隐匿性转移与年龄、性别、疾病持续时间、部位、肿瘤大小及病理分期的相关性，探讨cN0口腔鳞癌颈部转移规律及临床处理方式的选择。数据处理采用SPSS软件包及卡方检验相关性；定义P＜0.05时存在显著性差异。结果：85例cN0口腔鳞癌患者中，总隐匿性转移率为28.34%（24/85）。本研究中隐匿性转移的发生率由高到底依次为：口底鳞癌癌、磨牙后区鳞癌、颊部鳞癌、牙龈鳞癌、唇鳞癌、舌鳞癌。cN0口腔鳞癌患者淋巴结转移率与性别、发病部位无明显统计学意义（P＞0.05），与年龄、原发灶大小、病理分期及生长方式存在显著相关性（P＜0.05）。结论：cN0口腔鳞状细胞癌颈部隐匿性转移与年龄、肿瘤大小、病理分期、生长方式存在显著相关性，与性别、发病部位无明显相关性。患者年龄越小，，颈部淋巴结的隐匿性转移率越高，故对年轻患者需行颈部淋巴结清扫术。高分化鳞癌较中分化、低分化鳞癌其颈部淋巴结的隐匿性转移率低，高分化以外的口腔鳞状细胞癌需积极性颈部淋巴结的处理。肿瘤体积越大，其隐匿性转移率越高，且当肿瘤最大直径＞1cm时，需对颈部行积极处理。浸润型鳞癌较溃疡型及外生型鳞癌隐匿性转移率高，对此类患者需积极行相应颈部淋巴结清扫处理。
[Abstract]:Objective: to investigate the clinical data of cN0 oral squamous cell carcinoma (OSCC) with cervical lymph node negative (clinical lymphnode-negative cN0) in oral squamous cell carcinoma (oral squamous cell carcinoma,). OSCC) patients with occult metastasis of cervical lymph nodes and related factors to determine the need for simultaneous treatment of cervical lymph nodes. Methods: the clinical and pathological data of 85 patients with oral squamous cell carcinoma of cN0 who underwent cervical lymph node dissection from July 2008 to July 2013 in the first affiliated Hospital of Shihezi University were collected. The clinical and pathological data of patients with oral squamous cell carcinoma of the neck were analyzed retrospectively. To explore the relationship among the duration, location, tumor size and pathological stage of cN0 oral squamous cell carcinoma (OSCC), to explore the rule of cervical metastasis and the choice of clinical management. SPSS software package and Chi-square test were used in data processing, and there was significant difference in the definition of P < 0.05. Results: the total occult metastasis rate of 85 cN0 patients with oral squamous cell carcinoma was 28.34% (24 / 85). The incidence of occult metastasis in this study was: oral floor squamous cell carcinoma, posterior molar squamous cell carcinoma, buccal squamous cell carcinoma, gingival squamous cell carcinoma, lip squamous cell carcinoma and tongue squamous cell carcinoma. There was no statistical significance (P > 0.05), but there was significant correlation with age, size of primary lesion, pathological stage and growth pattern (P < 0.05). Conclusion: the occult metastasis in the neck of cN0 oral squamous cell carcinoma is significantly correlated with age, tumor size, pathological stage and growth pattern, but not with sex or location. The younger the patient is, the higher the occult metastasis rate of cervical lymph node is, so the younger patients need neck lymph node dissection. The occult metastasis rate of cervical lymph nodes in well-differentiated squamous cell carcinoma is lower than that in middle-differentiated squamous cell carcinoma, and the highly differentiated oral squamous cell carcinoma should be treated with positive neck lymph nodes. The larger the tumor size, the higher the rate of occult metastasis. Moreover, when the maximum diameter of the tumor is larger than 1cm, the neck should be treated positively. The rate of occult metastasis of invasive squamous cell carcinoma is higher than that of ulcerative and exogenic squamous cell carcinoma. Therefore, neck lymph node dissection should be carried out actively in these patients.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.8

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