游离下腹直肌肌皮瓣全舌再造术

目的 本文报告舌全切除术后下腹直肌肌皮瓣全舌再造的新方法。方法 先行患侧颈清及对侧舌骨上淋巴清扫术,保留对侧颌外动、静脉为供区血管。将全舌切除后取一侧下腹直肌肌皮瓣游离微血管吻合移植全舌再造。结果 下腹直肌肌皮瓣有恒定的下腹直肌深动、静脉血管为肌皮瓣之血管蒂。该蒂可取长约4-6cm,血管动脉直径3.5-5mm,静脉直径4-6mm,可与甲状腺上动、静脉、颌外动、静脉行端一端吻合,腹直肌与口底肌肉、皮瓣后端与舌骨、两侧前端与口底粘膜缝合。该肌皮瓣行舌再造后有足够的容积,能使患者最大限度地恢复吞咽及语言功能,结论 游离下腹直肌肌皮瓣微血管吻合行舌再造是一个可被推荐的新方法。     

股前外侧皮瓣修复舌癌术后舌再造的护理

目的:探讨股前外侧皮瓣移植修复舌癌术后舌再造的护理。方法:2003年12月至2007年6月,共有13例舌癌患者接受了舌癌联合根治术同期股前外侧皮瓣血管化移植修复术,对该类手术的护理体会进行总结。结果:经积极治疗及护理,本组病人术后无呼吸道及肺部并发症,无血管危象,无院内感染,供受区切口均一期愈合,股前外侧皮瓣成活,康复出院。结论:充分的术前准备,术后对皮瓣的观察与护理,以及对舌再造的功能指导是护理的重点。     

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??Objective??To select the best predictor of swallowing functions by exploring the correlation between the swallowing function and tongue mobility and tongue pressure of the patients with tongue defects after oral cancer surgery or oropharyngeal cancer surgery. Methods??From July 2017 to March 2018??in Hospital of Stomatology??Sun Yat-sen University??thirty-six cases of patients with tongue defects after oral cancer surgery or oropharyngeal cancer surgery were collected during return visits in the outpatient clinics of our hospital. The swallowing functions were graded by their water swallowing test??WST??results. The tongue mobility scores were evaluated by using the lingual range of motion??LROM??method??while the tongue pressure was measured by using the Iowa oral performance instrument??IOPI??. Spearman rank correlation analysis was applied to calculate the rank correlation coefficient??rs?? between the tongue mobility scores or tongue pressure and WST results??and the corresponding P value. Results??The rs value between WST results and tongue mobility scores or tongue pressure was -0.575 and -0.613 respectively??P??0.05??. The rs value of tongue pressure was larger than that of tongue mobility scores. Conclusion??Both the tongue mobility scores and tongue pressure have a great impact on the swallowing functions of patients with tongue defects after oral cancer surgery or oropharyngeal cancer surgery??and tongue pressure is the best predictor.     

口腔癌及口咽癌术后伴舌缺损患者吞咽功能的相关因素分析

目的　探讨口腔癌及口咽癌术后伴舌缺损患者吞咽功能与舌动度及舌压的相关性,筛选吞咽功能最佳预测指标。方法　选取2017年7月至2018年3月于中山大学附属口腔医院口腔颌面头颈肿瘤外科门诊复诊的口腔癌及口咽癌术后伴舌缺损患者36例,通过洼田饮水试验对其吞咽功能进行评级,应用舌运动范围法对其舌动度进行测量评分,同时利用爱荷华口腔行为仪测量其舌压。采用Spearman秩相关分析方法计算洼田饮水试验等级与舌动度评分及舌压之间的秩相关系数（rs）及相应的P值。结果　舌动度评分及舌压与洼田饮水试验等级的rs分别为-0.575和-0.613（均P＜0.05）;其中舌压与洼田饮水试验等级的rs值较舌动度评分的rs大。 结论　舌压与舌动度均可影响口腔癌及口咽癌术后伴舌缺损患者的吞咽功能,其中舌压是评估患者吞咽功能的最佳预测指标。     

Long‐term subjective tongue function after partial glossectomy

There have been limited studies of subjective tongue function over long‐term follow‐up in spite of swallowing and articulation disorders are common complications of glossectomy. To assess long‐term subjective swallowing and articulation function after partial glossectomy. A total of 63 patients with the mobile tongue cancer who underwent partial glossectomy without reconstruction were interviewed to score their swallowing and articulation function on a 100‐point scale. The relation of this subjective scoring to the perioperative data was subjected to multivariate analysis. The mean patient age was 53·4 (19–81) years, and the mean follow‐up duration was 78·9 (14–277) months. Mean swallowing and articulation function score was 87·7 ± 6·1 and 88·6 ± 5·4. Age, follow‐up duration, T stage and resection volume were significantly correlated with swallowing function (P = 0·026, 0·029, 0·016, 0·002, respectively); follow‐up duration was correlated with articulation function (P = 0·039). Patients who undergo partial glossectomy without reconstruction generally demonstrate good function on long‐term follow‐up. Subjective dysfunction was correlated with larger resection volume, older age and shorter follow‐up duration.     

40例舌癌组织VEGF表达及微血管密度观察

目的:探讨血管内皮生长因子(VEGF)表达及微血管密度(MVD)与舌癌组织临床病理指标的关系.方法:40例手术切除的舌癌原发病灶蜡块标本常规切片,免疫组化染色法观察各标本VEGF表达及MVD.结果:VEGF阳性表达的舌癌组织有较高的微血管密度(p＜0.01);VEGF表达和MVD在淋巴结转移组间有显著性差异(p＜0.01)、病理分型组间有显著性差异(p＜0.05),而在原发病灶临床分级组间差异无统计学意义(p＞0.05).结论:VEGF表达和MVD与舌癌病理分型及淋巴转移关系密切,可作为预测性检测指标.     

nm23-H1提高舌癌细胞Tca8113对顺铂化疗敏感性可能机制的研究

目的研究nm23-H1提高顺铂化疗敏感性的可能机制。方法实验分为nm23-H1转染组和未转染组,用MTT法检测顺铂对舌癌细胞的杀伤率;流式细胞仪检测细胞凋亡变化;用流式细胞仪检测线粒体结合罗丹明荧光强度,检测线粒体膜电位的变化;等离子质谱仪检测细胞内铂离子浓度变化。结果nm23-H1过表达可以明显提高顺铂对舌癌细胞的杀伤率,使细胞凋亡增强,线粒体膜电位降低,提高细胞内铂离子浓度。这种作用可以被哇巴因（Na+/K+-ATP酶的抑制剂）抑制。结论nm23-H1可提高顺铂对舌癌细胞化疗的敏感性,其可能机制是nm23-H1降低线粒体膜电位,铂离子进入细胞内增加,导致细胞凋亡或坏死。     

不同方法制备抗原致敏的树突状细胞介导T淋巴细胞对Tca8113细胞杀伤作用的影响

目的探讨树突状细胞（DCs）疫苗治疗舌癌的可行性,并选择较优的抗原负载方式。方法分别采用弱酸洗脱法、反复冻融法制备Tca8113细胞抗原,并分为3组：弱酸洗脱抗原组、反复冻融抗原组、对照组（不加肿瘤抗原）。从外周血单核细胞中诱导DCs,分离出T淋巴细胞。以不同效靶比将DCs和T淋巴细胞混合培养,MTT法测光密度值,计算刺激指数。DCs抗原负载后,与T淋巴细胞混合,以不同效靶比加入预先接种了Tca8113细胞的培养板。MTT法测光密度值,计算杀伤率。结果2种方法体外成功地构建了DCs疫苗,抗原致敏组与对照组比较差异显著,且弱酸洗脱组优于反复冻融组。DCs疫苗可诱导细胞毒性T淋巴细胞有效的杀伤Tca8113细胞,并表现明显的剂量效应。结论DCs疫苗致敏T淋巴细胞能够有效的杀伤Tca8113细胞,酸洗脱抗原冲击致敏的DCs疫苗在舌癌的免疫治疗中优于冻融抗原。     

The epidemiology of tongue cancer: a review of global incidence

The tongue (141 ICD-9) is the most common intraoral site for cancer in most countries, however its global epidemiology shows significant geographic variation. This review paper summarises the global incidence of cancer of the tongue using cancer maps and references to recent studies from various locations. Tongue cancer remains a serious health problem in many countries including India (male incidence rates up to 6.5 per 100,000 per annum) and parts of Europe (male incidence rates in France up to 8.0 per 100,000 per annum). It is noted that as with other forms of oral cancer the majority of population-based data for tongue cancer comes from the Western world with a paucity of reliable data from the so-called developing countries. The tongue remains the most common intraoral site for oral cancer worldwide and in a number of countries it is a serious public health problem with significant morbidity and mortality. While the incidence of tongue cancer appears to be stable or falling in some regions of the world, in other areas it is rising, particularly among younger people.     

TNP—470、顺铂联合应用抗人舌癌生长的实验研究

目的：研究血管生成抑制剂TNP－470对人舌癌生长的抑制作用。方法：MTT法 定TNP－470、顺铂（CDDP）对体外培养人舌癌Tca8113细胞增殖的抑制作用。用Tca8113细胞形成裸鼠肿瘤皮下移植模型,移植二周后腹腔注射用药,TNP－470（30mg/kg)隔日一次,共七次,CDDP（5mg/kg)一周二次,共四次,同期测量肿瘤体积和裸鼠体笪“移植四周后处死动物,检测肿瘤体积和主要脏器。结果：TNP－470作用Tca8113细胞的半数抑制浓度（IC50）为70．79μg/ml。TNP-470 CDDP组抑瘤率分别为31．7％、40．3％和65．6％,实验组与对照组之间抑瘤率有显著性差异（P＜0．05）,TNP－470＋CDDP组抑瘤效果最佳,结论TNP－470对人舌癌体内生长有一定抑制作用,联合应用CDDP可进一步提高治疗效果。     

免疫功能正常小鼠肾囊膜下移植舌癌模型的建立

目的：建立免疫功能正常小鼠肾囊膜下移植舌癌模型。材料和方法：利用ＳＲＣＡ 技术,建立移植舌癌模型,观察移植前后瘤体大小的变化,并对移植瘤进行病理切片观察。结果：舌癌移植后第６ 天瘤体增长率为８７．８％ （７／８）（Ｐ＜ ０．０５）,病理切片证实其为高分化性鳞癌。结论：小鼠肾囊膜下移植舌癌模型的建立具有可行性,它可为舌癌的基础与临床研究提供一个经济、快速、高效的动物模型。     

Oncological outcomes of total glossectomy procedure for advanced tongue cancer: a single-centre experience

Surgeons treating advanced carcinoma of the tongue with total glossectomy face many conflicts in view of the morbidity and poor functional and survival outcomes following surgery. It is pertinent to study the patients undergoing total tongue compartment resection as a separate cohort to analyse their outcomes. This study investigated the oncological outcomes of 150 patients with advanced tongue squamous cell carcinoma who underwent total glossectomy. The results suggest that compartment resection significantly improved local control, irrespective of margin status. The presence of multiple positive nodes was found to be an independent poor prognostic factor, and adjuvant radiation significantly improved survival. Total glossectomy is feasible and safe in both the primary and salvage setting and should be considered as the surgical option for advanced tongue cancer.     

50例老年舌癌患者围手术期护理

目的：探讨老年舌癌患者围手术期的护理方法。方法：对50例老年舌癌患者做好心理护理，严格术前准备，术后严密观察病情变化，做好呼吸系统、口腔及饮食护理，对实施皮瓣移植修复的患者做好并发症观察。结果：50例老年舌癌患者通过实施肿瘤切除和颈部淋巴结清扫术，加游离皮瓣移植修复及围手术期的护理，全部成功。结论：对老年舌癌患者在围手术期实施有效的护理方法至关重要，是促进患者尽早康复提升生命质量的重要措施。     

VEGFR3在不同临床分期舌癌癌周淋巴管中的表达

目的:研究血管内皮生长因子受体(VEGFR3)在舌癌淋巴转移中的作用,探索舌癌淋巴转移的机制。方法:采用免疫组化和RT-PCR技术,对90例不同分期的舌癌肿瘤进行VEGFR3的检测,与10例正常舌黏膜标本进行对照。采用SAS6.12软件进行单因素方差分析。结果:通过与正常组对照,Ⅰ、Ⅱ、Ⅲ期肿瘤中VEGFR3的表达无显著性差异(P>0.05),Ⅳ期肿瘤中VEGFR3的表达较正常对照组显著升高并具有显著性差异(P<0.05)。肿瘤各组间比较无显著性差异。转移组与非转移组之间也无显著性差异。结论:VEGFR3参与微淋巴管的生成,随着肿瘤的临床分期增高,其表达虽呈缓慢增高趋势,但尚不足以作为判定是否发生淋巴转移的客观指标。     

Two cases of tongue cancer treated with intra- and peri-tumoral injection of recombinant interleukin-2 alone: immunohistochemical considerations to clinical tumor response

SUBJECTS AND METHODS: Two cases with stage II tongue cancer who exhibited different responses to intra-and peri-tumoral administration of rlL-2 alone are presented. Special consideration is given to the relationship between tumor responses to rlL-2 and clinicopatholog-ical and immunohistopathological findings.
RESULTS: The patient who responded completely to treatment showed an exophytic tumor growth pattern, low-grade cancer invasion, and predominant infiltration of CD8⁺ lymphocytes over CD4⁺ lymphocytes in cancer cell nests. The non-responder showed endophytic tumor growth, high-grade cancer invasion, and uniform distribution of both CD4⁺ and CD8⁺ lymphocytes in cancer cell nests.
CONCLUSIONS: Distribution of adequate amounts of T lymphocytes subsets may be necessary in order for good tumor response to biotherapy with rlL-2; other clinical and histopathological variables predicting the effect for cancer chemotherapy remain to be identified.     

舌癌好发部位与慢性不良刺激的关系研究

目的:分析舌癌好发于舌缘、舌尖的原因。方法:36例舌癌病人按有无慢性不良刺激因子(包括残根、残冠、锐尖锐缘、倾斜牙、不良修复体)分为有刺激因子组和无刺激因子组,把发病部位分为经常受牙齿摩擦刺激的舌缘、舌尖部;和很少受牙齿摩擦刺激的舌腹、舌背、舌根部两亚组。结果:有不良刺激因子组和无不良刺激因子组中不同亚组的构成比有显著性差异,前者的舌缘、舌尖部的构成比(91.7%)显著高于后者(8.3%),而后者中不同亚组构成比相近(58.1%、41.7%)。结论:病患牙及不良修复体对舌的长期慢性不良刺激是舌癌好发于舌缘舌尖部的重要相关因素。     

Increased expression of peroxiredoxin 6 and cyclophilin A in squamous cell carcinoma of the tongue

Oral Diseases (2011) 17 , 328–334 Objectives: The aim of this study was to assess the expression levels of two proteins, such as PRDX6 and cyclophilin A (CypA), and to evaluate their relationship with clinicopathologic features and survival in tongue squamous cell carcinomas (TSCCs). Material and Methods: An immunohistochemical study was performed comprising a total of 42 tissue samples of patients suffering from TSCCs as well as 10 corresponding adjacent normal tissues. After detection of PRDX6 and CypA, their expression levels were semiquantitatively evaluated and correlated with clinicopathologic variables. Results: Both PRDX6 and CypA expressions were significantly higher in tissue samples of TSCCs compared with the 10 corresponding adjacent normal tissues ( P < 0.01). A statistically significant correlation in TSCCs regarding the expression of PRDX6 and CypA was revealed (P = 0.005), and the lymphadenectasis was correlated with PRDX6 (P < 0.05). Results of a multivariate analysis revealed age, CypA expression, cervical lymph node metastases, and tongue cancer differentiation to be independent prognostic variables in respect of the overall survival rate (P < 0.05). Conclusions: It could be detected that PRDX6 and CypA are associated with tumorigenesis in TSCCs. High levels of CypA expression may predict reduced survival time.     

白藜芦醇对人舌癌细胞Tca增殖及凋亡影响的研究

目的探讨白藜芦醇对人舌癌细胞Tca的增殖及凋亡影响。方法应用MTT比色法检测白藜芦醇对Tca细胞体外生长的抑制作用;平板克隆检测白藜芦醇处理前后Tca细胞的克隆形成能力;流式细胞仪测定细胞的周期和凋亡;Hoechst33258荧光染料染色,显示凋亡细胞形态。结果MTT实验观察,白藜芦醇对Tca细胞生长有抑制作用,随浓度升高和时间延长,作用增强,呈剂量-时间效应关系;白藜芦醇作用Tca细胞48 h和72 h后,半数细胞抑制作用所需浓度约为(IC50)100μmol/L和75μmol/L。白藜芦醇(75μmol/L)处理后,细胞的克隆形成能力明显下降。白藜芦醇(100μmol/L)作用48 h后使G1期细胞的比例增加;Hoechst33258染色,可见细胞呈明显的凋亡特征。结论白藜芦醇可抑制人舌癌细胞Tca增殖,使细胞周期呈G1阻滞并可诱导细胞发生凋亡。     

姜黄素对口腔舌癌细胞增殖与转移能力影响的实验研究

目的 探讨姜黄素对口腔舌癌细胞增殖与转移能力的作用及其作用机制.方法分别以0、5、10、20、30、60、100μmol·L-1姜黄素处理人舌癌细胞SCC-4 24 h,采用MTT法、侵袭实验、流式细胞仪、免疫荧光显微镜分别检测姜黄素对口腔舌癌细胞增殖与转移能力的影响.然后,采用cDNA微陈列芯片技术筛选和实时定鼍RT...