颊黏膜鳞癌颈淋巴结隐匿性转移的临床研究

目的:探讨颊黏膜鳞癌隐匿性转移规律。方法:1992-01～2004-12月在南京大学口腔医院口腔颌面外科行颈淋巴清扫术的颊黏膜鳞癌cN0患者69例,男性31例,女性38例,年龄31～79岁,平均58.2岁。颈部的处理采用根治性颈淋巴清扫术、功能性颈淋巴清扫术或肩胛舌骨上颈淋巴清扫术。结果:颊黏膜鳞癌颈淋巴结隐匿性转移率为14.49%(10/69),转移到Ⅰ区为10.14%(7/69)、Ⅱ区为5.80%(4/69)、Ⅲ区为2.90%(2/69);T1颈部隐匿性转移率为9.52%(2/21)、T2为15.38%(6/39),T3、T4例数较少,其中4例T3中有1例转移,5例T4中有1例转移;高、中分化鳞癌颈部隐匿性转移率分别为14.89%(7/47)、10.00%(2/20),低分化鳞癌例数较少,2例中有1例转移。结论:认识颊黏膜鳞癌颈部淋巴结隐匿性转移特征,对制定颈部治疗方案具有重要意义。

A clinical study on regional occult metastases for patients with squamous cell carcinoma of buccal mucosa

Objective:To assess regional occult metastases on clinical negative neck node [cN0] in patients with buccal mucosal squamous cell carcinoma. Methods:69 patients (31males and 38 females ) with cN0 buccal mucosa squamous cell carcinoma who underwent a lymph node dissection (at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Nanjing University Medical School) between 1992 and 2004, were retrospectively reviewed. The patients ranged in age from 31 to 79 years with a mean age of 58.2 years. All patients received radical neck dissection(RND), functional neck dissection (FND) or supraomohyoid neck dissection (SOND). Results:The incidence of occult metastases for patients with cN0 buccal mucosa squamous cell carcinoma was 14.49% (10/69).The distribution of the positive nodes was as follows: Level I,10.14%(7/69); Level II, 5.80% (4/69); Level III, 2.90%(2/69). The occult metastasis rate for patients with T1, T2, T3 and T4 was 9.52% (2/21), 15.38%(6/39), 25.00%(1/4), and 20.00%(1/5), respectively. In patients with well differentiated carcinoma,the occult metastasis rate was 14.89%(7/47); moderate differentiated,10.00%(2/20); and poorly differentiated,50.00%(1/2). Conclusion:The assessment of regional occult metastases for patients with cN0 buccal mucosa squamous cell carcinoma may play an important role in deciding treatment approaches of neck.