708例口腔鳞状细胞癌颈淋巴转移临床病理分析

目的 探讨口腔鳞状细胞癌颈淋巴转移的规律及相关临床病理学因素。方法 对708例行颈淋巴清扫术的口腔鳞状细胞癌患者进行回顾性研究，通过单因素和多因素回归分析，寻找影响口腔鳞状细胞癌颈淋巴转移的相关临床病理学因素。采用SPSS19.0软件包对数据进行统计学分析。结果 口腔鳞状细胞癌的颈淋巴转移率为35.6%(252/708)，各区的转移率分别为Ⅰ区30.7%（149/485）, Ⅱ区33.8%（164/485），Ⅲ区22.5%（109/485），Ⅳ区8.0%（39/485），Ⅴ区4.9%（24/485）。在单因素分析中，年龄、肿瘤分化程度、肿瘤浸润深度、pT分级均与口腔鳞状细胞癌颈淋巴转移显著相关（P＜0.05），而性别、原发灶部位与口腔鳞状细胞癌颈淋巴转移无显著相关性（P＞0.05）；在多因素分析中，仅肿瘤的分化程度、肿瘤的浸润深度、pT分级与口腔鳞状细胞癌颈淋巴转移有明显相关性（P＜0.05），肿瘤浸润深度可能是口腔鳞状细胞癌发生颈淋巴转移的首要影响因素（OR=2.191）。结论 口腔鳞状细胞癌颈淋巴转移与pT分期、肿瘤浸润深度呈正相关，与肿瘤分化程度呈负相关。肿瘤浸润深度可能是口腔鳞状细胞癌颈淋巴转移的首要影响因素。

Clinicopathologic analysis of cervical lymph node metastasis in 708 patients with oral squamous cell carcinoma

PURPOSE To investigate the characteristics of cervical lymph node metastasis in oral squamous cell carcinoma (OSCC), and the relationship between clinicopathologic factors of OSCC and cervical lymph node metastasis (CLNM). METHODS Clinicopathologic data of 708 patients with OSCC who underwent neck dissection were retrospectively analyzed. The relationship between clinicopathologic factors of OSCC and CLNM was analyzed with univariate analysis and multivariate analysis using SPPPSS19.0 software package. RESULTS The incidence of CLNM of OSCC was 35.6%(252/708), and the incidence of CLNM at each level was：levelⅠ30.7%（149/485）, level Ⅱ33.8% (164/485), level Ⅲ22.5% (109/485), level Ⅳ8.0% (39/485), and levelⅤ4.9% (24/485), respectively. From univariate analysis of the results, age, differentiation degree, depth of invasion, pathological T stage were significantly correlated with CLNM (P＜0.05); while gender, location were not significantly correlated with CLNM (P＞0.05). From multivariate analysis of the results, only differentiation degree, depth of invasion and pathological T stage were significantly correlated with CLNM (P＜0.05). Depth of invasion was probably the most important influential factor for CLNM of OSCC (OR=2.191).CONCLUSIONS There was positive relationship between CLNM and pathological T stage , depth of invasion; while there was negative relationship between CLNM and differentiation degree. Depth of invasion was probably the first influential factor for CLNM of OSCC.