舌鳞癌患者血浆纤连蛋白测定的临床意义

为探讨舌鳞癌患者血浆纤连蛋白测定的临床意义。采用火箭电泳免疫法检测了３３ 例舌鳞癌及３７ 例正常人血浆纤连蛋白的含量。发现舌鳞癌病人血浆纤连蛋白含量（０ ．５３６ ｇ／Ｌ±０ ．１１８ ｇ／Ｌ）明显高于正常人（０．３５９ ｇ／Ｌ±０ ．０６２ ｇ／Ｌ）,Ｐ＜０ ．０１ ;晚期及伴颈淋巴结转移的舌鳞癌病人血浆纤连蛋白含量也明显高于相应的早期与无颈淋巴结转移的舌鳞癌病人（Ｐ＜ ０．０１）。结果显示血浆纤连蛋白含量测定对舌鳞癌的诊断,以及肿瘤恶性与转移的判断有一定的参考价值     

Tongue swelling as a manifestation of tongue metastasis from pulmonary sarcomatoid carcinoma: A case report

BACKGROUNDSarcomatoid carcinoma is a rare subtype of non-small-cell lung cancer, commonly associated with locally advanced disease, early metastasis, and poor prognosis. Tongue metastasis from lung cancer is a rare condition that may occur in advanced stage of the disease.CASE SUMMARYThe patient was a 70-year-old female with a history of resected pulmonary sarcomatoid carcinoma (PSC) who presented with subacute tongue swelling, imparting the clinical impression of a lingual abscess. However, histologic examination of the partial glossectomy revealed a high-grade, poorly differentiated spindle and epithelioid carcinoma consistent with metastatic PSC.CONCLUSIONAlthough uncommon, clinicians should be cognizant of the possibility of a metastatic process to the tongue mimicking a benign or inflammatory process. A high index of suspicion for metastatic disease should be maintained when tongue swelling is observed in patients with a known history of PSC.     

143例舌体鳞状细胞癌年轻患者的预后因素

目的探讨舌体鳞癌年轻患者的预后及其影响因素。方法回顾性分析143例45岁以下舌体鳞癌患者的临床资料,采用Kaplan-Meier法计算累积生存率,采用log-rank法比较各因素不同水平生存分布的差异,应用Cox比例风险模型进行多因素生存分析。结果全组5年累积生存率为62.2%,10年累积生存率为60.5%。单因素分析显示：有无浸润肌层、不同病理分级、T分级、N分级、TMN分期、原发灶有无行根治性手术治疗、有无颈部淋巴结清扫术的生存差异有统计学意义。多因素分析显示：T分级、N分级是影响预后的独立因素。结论T分级和N分级是45岁以下舌体鳞癌患者的独立预后因素,原发灶手术治疗、颈部淋巴结清扫彻底以及合理的综合治疗,可能改善舌体鳞癌年轻患者的预后。     

Tongue cancer treatment and oncological outcomes: The role of glossectomy classification

BackgroundNowadays surgery remains the gold standard of treatment for tongue cancer. Via a more clear and precise terminology, the glossectomy classification by Ansarin et al. facilitates shared communication between surgeons, allowing comparison between published research and improving surgical practice and patient care. To establish the association of glossectomies, according to their classification by Ansarin et al. with overall survival (OS), disease-free survival (DSF), and cause-specific survival (CSS) in tongue cancer, we conducted a systemic retrospective study on 300 consecutive patients affected by primary oral tongue cancer and treated with surgery at the European Institute of Oncology, IRCCS (IEO).MethodsThree hundred patients with tongue squamous cell carcinoma and treated at the Division of Otorhinolaryngology and Head and Neck Surgery of the European Institute of Oncology, IRCCS were cataloged according to the glossectomy classification. OS, DFS, and CSS were compared by surgical treatments.ResultsOS-5yrs was 80% for the type I glossectomy group, 75% for type II, 65% for type III, and 35% for type IV-V. DFS-5yrs was 74%, 60%, 55%, and 27%, respectively for I, II, III, and IV-V glossectomy group; CSS-5yrs was 82%, 80%, 72%, and 48%, respectively for I, II, III, and IV-V glossectomy group (p < 0.01).ConclusionsThis study confirmed that the application of the glossectomy classification was statistically correlated with patients' oncological outcomes.     

舌鳞癌纤维连接蛋白的表达及意义

目的：探讨纤维连接蛋白在舌鳞癌中的表达及意义。方法;采用免疫组织化学,免疫荧光和火箭免疫电泳技术,分别研究了ＦＮ在体内舌鳞癌发生,发展中和体外培养的舌鳞癌细胞上的表达及舌鳞癌患者血浆中的浓度。结果;基膜ＦＮ的表达与舌上皮恶变及舌鳞癌的分化相关,而与转移无关;体外培养的癌细胞ＦＮ为阳性;舌鳞癌患者中血浆中ＦＮ的浓度也明显高于正常人。     

间隙连接蛋白 43在舌鳞状细胞癌中的表达及意义

目的：探讨间隙连接蛋白43（connexin43,Cx43) 在舌癌中的表达及意义。方法：对6例正常舌上皮、24例不同分化程度舌癌的石蜡包埋切片用定量免疫组化检测Cx43蛋白的表达,同时应用流式细胞仪和免疫细胞化学对舌癌细胞株（Tca8113)Cx-43蛋白的表达进行检测。结果：正常 舌上皮中Cx43蛋白定位于棘细胞层的胞膜上,Cx-43阳性表达的 面积和灰度值在正常舌上皮和高分化舌癌之间无显著性差异（P＞0．05）,但Cx43阳性表达的面积随着舌癌细胞分化程度的下降显著降低（P＜0．01）,而且在舌癌组织中Cx－43异常表达于细胞浆。流式细胞仪 和免疫细胞化学检测可见舌癌细胞中Cx43弱表达,细胞阳性率仅为4．8％,而正常舌上皮则为92．3％。结论：该结果提示Cx43表达的改变与舌癌的进展和分化相关。     

下颌骨旁正中劈开术在中晚期舌鳞癌治疗中的应用

目的 探讨中晚期舌鳞癌术前明确原发灶未侵犯下颌骨,行下颌骨旁正中劈开术在中晚期舌鳞癌联合根治术中的可行性、必要性及其方法.方法 对15例初治的中晚期的舌鳞癌患者,术前行平阳霉素化疗或者顺铂 5-Fu 博莱霉素4～6个周期,化疗结束后,评估原发灶.结果 随访至少5年,1例失访,其中术后2年内原发灶复发2例,术后第3年复发2例.远处转移2例,局部淋巴结复发1例.结论 对于未侵犯下颌骨的中晚期舌鳞癌患者,严格掌握此术式的适应证,行下颌骨旁正中劈开治疗中晚期舌鳞癌是可行的,且有助于彻底的切除原发肿瘤,减少肿瘤的复发,提高患者的生存率.     

舌癌224例根治性手术后立即整复

本文报告我科1978年1月～1987年12月10年间224例舌癌联合根治术后应用各类组织瓣一期重建缺损的治疗经验。移植234块组织瓣的总成功率为94.0％。作者指出:游离前壁皮瓣手术简单,成功率高,是理想的半舌切除后舌再造的首选皮瓣。胸大肌肌皮瓣或背阔肌肌皮瓣能提供丰厚的组织,适用于全舌、全口底切除后的整复。肋骨背阔肌或肋骨胸大肌肌皮瓣则适用于全舌、口底和下领骨联合根治性切除术后缺损的立即整复。     

舌鳞状细胞癌复发相关因素分析

目的探讨影响舌鳞状细胞癌复发的相关因素。方法回顾性研究131例舌鳞状细胞癌患者的临床病理资料,采用χ^2检验和Logistic回归模型分析11个临床病理因素与其复发的关系。结果局部和区域共复发57例,总复发率为43．5％,肿瘤体积为舌鳞癌复发的独立影响因素（P=0．000）;区域复发34例,区域复发率为26．0％,颈部淋巴结转移与区域复发相关（χ^2=11．603,P=0．001）。结论肿瘤体积是影响舌鳞癌复发的最重要因素,可作为评估舌鳞癌复发风险的指标之一;颈部淋巴结转移是舌鳞癌区域复发的重要影响因素,手术治疗应作为舌鳞癌颈部的主要治疗方法。     

影响舌鳞状细胞癌患者预后的临床病理因素分析

目的：研究影响舌鳞状细胞癌患者预后的临床病理因素，方法：应用临床病理指标分析舌鳞状细胞癌患者预后的相关因素。结果：肿瘤分化程度，淋巴细胞浸润程度与区域淋巴结转移无关；肿瘤大小与区域淋巴结转移有关，肿瘤大小，淋巴细胞浸润程度与术后发生转移无关，分化程度与术后复发转移有关，结论：对于肿瘤直径大的舌鳞状细胞癌应积极采取病灶切除及颈淋巴结清扫术，肿瘤分化程度低者术后易出现复发转移。     

Carcinoma of the Tongue: A Case-control Study on Etiologic Factors and Dental Trauma

Background: Carcinoma of the tongue is the most common intra-oral malignancy in Western countries.Incidence and mortality rates have increased in recent years, and survival has not improved. This study aimedto determine etiologic factors for tongue cancer with age-sex matched case-control data. Materials and Methods:47 patients with carcinoma of the tongue referred to our oral medicine clinic between years 2005-2006 wereanalyzed and compared with control group data. The medical records , including family history of cancer,dental trauma, and history of abuse of alcohol and tobacco products was recorded for all subjects. Chi squarecomparison tests and linear regression analysis were performed using the SPSS program for statistics. Results:Patient and randomly selected control groups each consisted of 30 male and 17 female subjects with mean ages53.2 (±12.6) and 52.6 (±11.5) years respectively. Smoking and alcohol abuse proportions were significantly higherin the patient group (p=0.0001, p<0.0001 respectively). Chronic mechanical trauma was observed in 44.7% of thepatients and 17.0% of the control group (p=0.004). Similarly, family history of cancer of any type (for the firstdegree relatives) was found to be more common in the patient group (p=0.009). On regression analysis, alcoholabuse, family history of cancer, smoking, chronic mechanical traumas appeared as significant etiologic factors(p=0.0001). Conclusions: We believe that field cancerization may become evident in oral and oropharyngealmucosa with multiple steps of molecular changes starting from the first sign of dysplasia with chronic exposureto etiological factors. Chronic trauma cases need particular attention to search for very early signs of cancer.     

Role of Human Papilloma Virus in Oral Tongue Squamous Cell Carcinoma

Background: Human papilloma virus (HPV) is an important risk factor for head and neck cancer, specificallyoropharyngeal cancer, but its association with oral tongue squamous cell carcinoma (SCC) is uncertain. Theobjectives were to determine the HPV16 prevalence in oral tongue SCCs, its integration status and to correlatethe expression of oncogenic proteins with targets. Methods: In this case-control study with oral tongue SCC cases(n=60) and normal oral mucosa (n=46), HPV positivity was determined by polymerase chain reaction (PCR)using consensus and HPV 16 type specific primers and p16 immunohistochemistry (IHC). The viral integrationstatus was determined with primers specific to the E2 gene and in situ hybridization (ISH). Immunohistochemicalanalysis of HPV oncogenic proteins (E6, E7) and their target proteins (p53, pRb, cyclinD1, p16, Notch-1, EGFR)proteins was carried out in HPV positive cases. The data was analyzed with SPSS software (v 11.0). Survivalanalysis was carried out by the Kaplan-Meier method. Results: HPV16 was detected in 48% (n=29) of the casesand none of the controls by PCR assay (p<0.001) while p16 IHC, as a surrogate HPV marker, detected 33%(n=18) of the cases; 18% (n=10) were detected by both the methods. Integration was observed in 83% (n=24)by E2-PCR and 67% (n=18) by ISH. The E6-p53 pathway was active in 33% of the cases; E7-pRb in 52% andboth in 11%. HPV positivity was associated with well-differentiated cancers (p=0.041) and low recurrence rate(p=0.014). Conclusion: Our study confirms a positive correlation of HPV infection with oral tongue cancer.     

舌癌手术治疗与插植放疗的疗效对比分析

目的比较分析手术治疗与插植放疗对各期舌癌的疗效。方法采用Kaplan-Meier法,比较分析133例舌癌患者行手术治疗及行放疗的疗效。结果手术组3、5年生存率分别为76.3%、67.7%,平均生存时间82.4个月;放疗组3、5年生存率分别为55.0%、35.0%,平均生存时间56.3个月,χ2=15.22,P=0.000。手术组与放疗组中Ⅰ期舌癌患者平均生存时间分别为76.0和98.9个月,P=0.703,两组中Ⅱ、Ⅲ期舌癌患者平均生存时间分别为74.0、40.2个月及88.9、29.3个月,P值分别为0.027及0.001。两组中Ⅳ期患者平均生存时间分别为48.7个月及27.5个月,P=0.126。结论Ⅱ、Ⅲ期舌癌患者手术治疗疗效较放疗佳,Ⅳ期舌癌患者外放疗加插植放疗疗效良好。     

229例晚期舌鳞癌患者的生存和预后分析

背景与目的:晚期舌癌的的治疗欠规范,预后更差,目前针对晚期舌癌预后的相关因素等方面的研究较少,本研究旨在探讨影响晚期(Ⅲ～Ⅳ期)舌鳞状细胞癌患者预后的临床病理因素.方法:选择1985年1月至1999年12月间中山大学附属肿瘤医院首治的经病理确诊且随访资料完整的晚期舌鳞癌患者共229例.应用Kaplan-Meier法分析生存结果,通过Cox回归模型确立影响预后的独立因素.建立预后风险预测函数并进行可靠性分析.结果:229例晚期舌鳞癌患者的平均生存时间为80.33个月,2年和5年生存率分别为50.66%和37.99%.单因素分析显示,影响晚期舌鳞癌患者预后的因素包括年龄、侵犯舌根、淋巴结转移、分期、手术治疗及有无复发和肿瘤残留等.多因素分析得出影响预后的独立因素为肿瘤侵犯中线、淋巴结转移、手术治疗及肿瘤残留或复发.预后风险预测函数能够较好地预测预后.结论:晚期舌鳞癌患者预后差,影响预后的独立因素为肿瘤侵犯舌中线、淋巴结转移、手术治疗及有无复发和肿瘤残留.     

脆性组氨酸三聚体基因在舌鳞状细胞癌中的表达及意义

目的探讨脆性组氨酸三聚体基因在舌鳞状细胞癌中的表达及其意义。方法应用免疫组化SP法检测30例舌鳞状细胞癌和12例正常舌粘膜鳞状上皮组织中FHIT的表达情况。结果舌鳞状细胞癌组织中FHIT的阳性率(40.0%)显著低于正常舌粘膜组织(75.0%)(P<0.05)。FHIT的表达与年龄、性别无关(P>0.05),而与分化程度相关,分化程度越低,FHIT的失表达越明显(P<0.05)。结论FHIT可能在舌癌的发生发展中发挥重要作用。     

Characteristics of Oral Tongue and Base of the Tongue Cancer: A Hospital Cancer Registry Based Analysis

Background: Tongue cancer is one of the leading sites of cancer in our population. Aim: To evaluate thesocio-demographic profiles and stages at diagnosis of oral tongue (OT) and base of tongue (BT) cancers, andidentify any possible variations in characteristics. Materials and Methods: A retrospective analysis was conductedon tongue cancer cases, divided into OT and BT, registered at the hospital cancer registry of North-East Indiaduring January 2010 to May 2013. Cases were analyzed for age, gender, residential status and different levels ofeducation for patients, the stage at diagnosis and presence of distant metastasis. Results: A total of 1,113 casesof tongue cancers were registered, 846(76.1%) of BT and 267(23.9%) of OT. While 33.9% of BT cancer patientswere above 65 years of age, the figure for OT cancers was 18.4%, stages III and IV accounting for 90.8% and77%, respectively. The relative risk for distant metastasis in OT cancers was 3.3 (95% CI 1.08-10.1, p=0.03).Conclusions: In the subsites of tongue cancers in our population, the majority arose from the base of tongue,these tending to occur in older individuals and presenting at late stage.     

舌癌患者术后生存质量及其影响因素分析

目的 分析舌癌患者术后生存质量及其影响因素.方法 选取舌癌患者71例,均行手术治疗.收集患者性别、年龄、文化程度、病理分化程度、浸润深度等临床资料,依据华盛顿大学生存质量问卷(UW-QOL)统计评分,分析术后生存质量的影响因素.结果 病理分化程度、浸润深度、T分期、N分期、局部区域复发、有无吸烟史、颈清方式、是否放疗是...     

α-烯醇化酶在舌鳞状细胞癌患者顺铂化疗耐药中的作用及其临床意义

目的探讨α-烯醇化酶(α-enolase,ENO1)在舌鳞状细胞癌患者顺铂化疗耐药中的作用,及其与临床病理特征、预后的关系。方法选取接受过顺铂化疗的舌鳞状细胞癌患者石蜡标本87例,用免疫组化法检测舌鳞状细胞癌细胞中ENO1蛋白表达变化,分析ENO1表达与其临床病理特征的关系。对所有患者进行随访,采用Kaplan-Meier进行生存分析。结果顺铂处理后,舌鳞状细胞癌各细胞系中ENO1蛋白表达水平均升高。ENO1高表达与肿瘤TNM分期、淋巴结转移及复发相关(P <0. 05),与患者年龄、性别及分化程度无相关性(P> 0. 05);Kaplan-Meier生存分析显示,ENO1高表达患者的平均生存时间短于ENO1低表达患者(P <0. 05)。结论顺铂化疗诱导了舌鳞状细胞癌ENO1蛋白表达上调,升高的ENO1水平提示患者顺铂耐药、预后不良,这可以为临床使用顺铂提供重要的用药指导。