影响舌鳞状细胞癌预后的临床病理因素分析

目的 研究影响舌鳞状细胞癌预后的临床病理因素。方法 以TNM分类,病理分级,淋巴细胞浸润程度,浸润厚度,病理核分裂数,微血管数等指标来研究与舌鳞状细胞癌预后有关的因素。结果 分化程度,淋巴细胞浸润程度,浸润厚度,微血管数,病理核分裂数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,微血管数等指标与术后复发转移无关,浸润厚度,分化程度,病理核分裂数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颈淋巴结清扫术;分化程度低者易出现术后复发转移;舌鳞状细胞癌浸润厚度超过6mm时,病理核分裂数大于2个／税镜视野时,易出现术后复发转移。     

MRI测量和评估口腔黏膜鳞状细胞癌临床分期指标的准确性分析

目的 ：研究磁共振成像（MRI）测量和评估口腔黏膜鳞状细胞癌（oral squamous cell carcinoma,OSCC）临床分期指标的准确性。方法：纳入2020年2月—2022年9月就诊于中国科学技术大学附属第一医院的OSCC患者71例,记录MRI测量的肿瘤最大直径（maximum tumor diameter,MTD）、浸润深度（depth of invasive,DOI）以及最大值截面,按相应截面制作病理切片,测量病理MTD和DOI值并进行统计分析,将MRI图像评估的患者颈淋巴结状态与术后病理证实的淋巴结状态进行比较,分析术前MRI测量和评估临床分期的准确性。采用SPSS 26.0软件包对数据进行统计学分析。结果：MRI Gd-T1WI序列测量的DOI平均较病理结果高出2.54 mm(95%CI:3.56～1.53,P<0.05),相关系数r为0.984;T2WI序列测量的DOI平均较病理结果高出3.09 mm (95%CI:4.88～1.29,P<0.05),相关性系数r为0.953。Bland-Altman散点图显示,Gd-T1WI序列的测量结果与病理DO...     

3．0TMRI在舌鳞状细胞癌术前诊断和临床评估中的应用价值

目的：探讨3．0 T高场强MRI成像技术在舌鳞状细胞癌术前诊断和临床评估中的应用价值。方法：回顾性分析本院经手术和病理证实为舌鳞癌的26例病例术前3．0 T MRI影像资料。结果：3．0 T MRI可以清晰显示舌鳞癌及其侵犯的范围,同时了解颌下及颈部淋巴结情况,对TN分期具有重要意义。结论：3．0 T MRI对舌鳞癌的显示和诊断具有高分辨率、多方位及多序列成像优势,可以很好地显示舌鳞癌发生的位置、大小、病变侵及范围以及扩散途径,有助于术前病变性质的判断及肿瘤分期的评估。舌鳞癌检查首选高场强MRI。     

舌鳞状细胞癌颈淋巴结转移的特点和评估处理

舌鳞状细胞癌位居口腔癌首位,颈淋巴结转移妨碍其治疗.颈淋巴结转移分为微转移和包膜外转移,前者与肿瘤预后较差相关,后者对患者的生存率影响更大.舌鳞状细胞癌的淋巴结转移多为Ⅰ～Ⅲ区,原发灶浸润深度对颈部隐匿性淋巴转移有较高的预测价值.舌鳞状细胞癌颈淋巴结转移存在着一定的规律性,与其病理分级、神经和血管侵犯、浸润深度等多方面因素相关.颈淋巴结转移的临床评估除需借助B超、CT、磁共振成像、正电子发射断层摄影术等影像学辅助检查技术外,还需借助细胞细针吸取活检和前哨淋巴结活检来确认.迄今有关舌鳞状细胞癌的颈淋巴结处理仍无定论,临床选择上存在着仁者见仁智者见智的现象.目前,舌鳞状细胞癌的颈淋巴结处理主要为颈淋巴结清扫和随访观察两种方式,早发现、早诊断、早治疗仍是解决其问题的主要方式.     

舌鳞状细胞癌化疗放疗后组织学的改变

本文对我院口腔颌面外科85～89年、经术前活检证实为舌鳞状细胞癌的病例、经术前诱导化疗或化疗加放疗后.行舌颌颈根治术的45例标本进行研究,以便了解舌鳞状细胞癌化疗或化疗加放疗后组织学的改变.     

MMP-9在不同浸润方式舌鳞状细胞癌中的表达及临床意义

目的:探讨基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)在不同浸润方式的舌鳞状细胞癌(tongue squamous cell carcinoma,TSCC)中的表达差异。方法:参照Anneroth等描述的肿瘤浸润方式对65例舌鳞状细胞癌进行分型,运用免疫组化链霉卵白素-过氧化酶法观察MMP-9在舌鳞状细胞癌中的表达。结果:在不同浸润方式的舌鳞状细胞癌,MMP-9的表达不同。在Ⅲ、Ⅳ型的舌鳞状细胞癌中,MMP-9的表达明显高于Ⅰ、Ⅱ型,而且临床易出现淋巴结转移。结论:MMP-9与舌鳞状细胞癌的浸润方式密切相关,其在舌鳞状细胞癌中的高表达可能与舌癌的浸润与早期淋巴转移密切相关。     

cT1N0M0期舌鳞状细胞癌颈淋巴结处理的临床观察与研究

目的:观察与研究选择性颈部淋巴结清扫术对于cT1N0M0期舌鳞状细胞癌的疗效及其与肿瘤浸润深度、分化程度,患者生存情况、生存率的关系.方法:回顾36例cT1N0M0期舌鳞状细胞癌患者的资料,将患者分为选择性颈部淋巴结清扫组(选择性颈清组,23例)和观察组(13例).对患者的临床病历、随访资料、病理结果等进行分析.结果:...     

低氧诱导因子-1α在舌鳞状细胞癌中的表达及其与临床预后的关系

目的:探讨低氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)在舌鳞状细胞癌(tongue squamous cellcarcinoma,TSCC)中的表达及其对临床预后的影响。方法:收集舌鳞状细胞癌组织标本49例以及相应癌旁组织标本15例。免疫组织化学法检测其中HIF-1α的表达。临床随访所选病例患者情况,将随访结果与HIF-1α表达情况进行统计分析。Kaplan-Meier方法分析无病生存期(DFS)和总生存期(OS)生存曲线,Log-Rank分析临床病理学参数与HIF-1α表达之间的意义。多变量Cox回归分析临床参数和HIF-1α表达之间的相关性。结果:在49例舌鳞状细胞癌标本中有43例表达HIF-1α,表达率为87.76%;而在癌旁组织中的表达率为33.33%,差异有统计学意义(P<0.05)。HIF-1α过表达与T分级(P=0.01)、组织分化(P<0.001)和淋巴结转移(P=0.05)密切相关。同时,HIF-1α过表达、组织分化和淋巴转移均与患者5年生存率(P<0.001,P=0.008,P<0.001)和无病生存率(P=0.01,P=0.020,P<0.001)密切相关。Cox比例风险回归模型表明,HIF-1α的过表达以及淋巴转移是影响舌鳞状细胞癌的预后独立因素。结论:舌鳞状细胞癌中存在HIF-1α的表达,HIF-1α的过表达预示舌鳞癌患者的预后较差。在舌鳞癌的检测与治疗中,它可能作为一个新的靶点发挥作用。     

舌鳞状细胞癌浸润方式与癌淋巴管生成的特点及临床意义

目的探讨不同浸润方式舌鳞状细胞癌淋巴管生成的特点及临床意义。方法 参照Anneroth等描述的肿瘤浸润方式对41例舌鳞状细胞癌进行分型,应用免疫组化法,以D2-40标记淋巴管,计数淋巴管密度（lymphatic vessel density,LVD）。结果不同浸润方式的舌鳞状细胞癌D2-40的表达不同,浸润方式为Ⅲ、Ⅳ型的舌鳞状细胞癌,淋巴管密度（LVD）显著高于Ⅰ、Ⅱ型（P〈0.05）,且临床易出现淋巴结转移。结论Ⅲ、Ⅳ型浸润方式的舌鳞状细胞癌恶性程度高,可能具有较强的诱导淋巴管生成的能力。     

血管内皮生长因子-C在不同浸润方式的舌鳞状细胞癌中的表达

目的 探讨血管内皮生长因子(VEGF)-C在不同浸润方式的舌鳞状细胞癌中的表达差异.方法 参照Anneroth等描述的肿瘤浸润方式对39例舌鳞状细胞癌进行分型,免疫组织化学染色观察VEGF-C的表达情况.结果 在不同浸润方式的舌鳞状细胞痛,VEGF-C的表达不同.在Ⅲ、Ⅳ型的舌鳞状细胞癌,VEGF-C的表达明显高于Ⅰ、...     

The accuracy of magnetic resonance imaging to measure the depth of invasion in oral tongue cancer: a systematic review and meta-analysis

The accuracy of magnetic resonance imaging (MRI)-derived depth of invasion (DOI) compared to histopathological DOI is still controversial. A meta-analysis was performed to address this controversy and further investigate the best imaging sequence to measure DOI of tongue squamous cell carcinomas (SCC). A comprehensive literature search of five electronic databases was conducted. Stata/SE was used to establish a continuous variable model to assess the consistency between MRI-derived DOI and histopathological DOI. IBM SPSS Statistics 22.0 was used to evaluate the correlation between MRI-derived DOI and histopathological DOI. The meta-analysis showed that the weighted mean difference (WMD) of DOI measured by MRI had an acceptable overestimation compared with that measured by histopathology (WMD 1.64 mm; P < 0.001). In the subgroup analyses, there was no difference between T1-weighted imaging (T1WI) and histopathological values (WMD 0.77 mm; P = 0.273), while T2-weighted imaging (T2WI) had a major overestimation (WMD 2.09 mm; P < 0.001). The overall inter-class correlation coefficient (ICC) between MRI-derived DOI and histopathological DOI was 0.869 (95% CI 0.837–0.895), and was 0.923 (95% CI 0.894–0.944) in the T1WI subgroup and 0.790 (95% CI 0.718–0.845) in the T2WI subgroup. MRI is an accurate modality for evaluating the DOI in oral tongue SCC, and T1WI showed relatively higher validity than T2WI for DOI measurements.     

The high prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma

BACKGROUND: Although many histopathologic factors in squamous cell carcinoma of the tongue predict the prognosis, the major predictive factors have not been identified clearly. This study analyzed the prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma. METHODS: The clinicopathologic features of 124 consecutive patients seen between January 1985 and December 1999 with previously untreated squamous cell carcinoma of the tongue were reviewed. Their mean age was 58.5 years (range: 23-90) and the male-female ratio was 1.8: 1 (79 men and 45 women). There were 41, 40, 30, and 13 cases at stage I to stage IV, respectively. The clinicopathologic factors, especially the histologic grade at the deep invasive front (invasive front grade, IFG), were analyzed to determine factors predicting prognosis. RESULTS: The 5-year disease-free survival rate of the patients treated with curative aim only was 66.7%. Clinicopathologic factors significantly associated with the prognosis were T classification, tumor size, stage classification, tumor depth, macroscopic appearance, cervical lymph node metastasis (nodal metastasis), microvascular invasion, and IFG. In a multivariate analysis, patients with tumor depth >/=4 mm, IFG >/=8 points, and nodal metastasis had a reduced disease-free survival and IFG >/=11 points had a predictive value for nodal metastasis (odds ratio: 7.34; P = 0.0019). CONCLUSION: This study found that a high IFG malignancy score had a high prognostic value for squamous cell carcinoma of the tongue.     

实时荧光定量RT-PCR检测舌癌E-cadherin mRNA的表达

目的:了解E-cadherin在舌癌中的表达及其临床意义.方法:采用实时定量PCR检测29例舌鳞癌患者的癌组织和正常组织中E-cadherin mRNA,分析E-cadherin基因表达与临床病理参数的相关性.结果:舌癌组织中E-cadherin mRNA表达水平2.23±1.16(E-cadherin/β-actin),低于正常组织组8.59±2.71,两组间差异有统计学意义(P＜0.01),E-cadherin mRNA水平与临床病理参数之间无相关性(P＞0.05).结论:E-cadherin的表达下降是舌癌发生过程中的重要事件,实时定量PCR检测E-cadherinmRNA的表达对舌癌早期诊断有重要参考价值.     

cN0期舌鳞癌患者颈淋巴结转移的相关因素及预后分析

目的: 探讨cN0期舌鳞癌患者颈淋巴结转移的相关因素及术后生存质量,为临床预测颈部隐匿性转移及提高生存率提供理论依据。方法: 收集南京医科大学附属淮安第一医院cN0期舌鳞癌患者283例,通过卡方检验及Logistic回归分析颈淋巴结转移与患者临床病理参数之间的相关性,通过单因素及多因素Cox回归分析探讨舌鳞癌患者预后的独立危险因素,通过生存分析研究颈淋巴结转移与患者预后之间的相关性。采用SPSS 21.0软件包对数据进行统计学分析。结果: 卡方检验及Logistic回归分析表明,浸润深度、T分期、病理学分级与颈淋巴结转移密切相关（P<0.05）,而浸润深度是导致术后颈淋巴结转移的主要因素（OR=2.175）;浸润深度、病理分级及颈淋巴结转移与舌鳞癌患者预后密切相关（P<0.05）。结论: 浸润深度、T分期、病理学分级可作为预测cN0期舌鳞癌隐匿性颈淋巴结转移的指标,浸润深度、病理分级及颈淋巴结转移可作为预测cN0期舌鳞癌患者预后的指标。     

Cystatin B与Cystatin C在舌鳞状细胞癌中的表达及意义

目的　研究半胱氨酸蛋白酶抑制剂B(Cystatin B)与半胱氨酸蛋白酶抑制剂C(Cystatin C)在舌鳞状细胞癌中的表达及意义并探讨其在舌鳞状细胞癌中的作用.方法　收集于2010年1月—2011年1月在中国医科大学附属口腔医院口腔颌面外科就诊的50例舌鳞状细胞癌病例标本及临床病理资料,行免疫组化方法检测Cystatin B与Cystatin C在舌鳞状细胞癌及癌旁正常组织中的表达,进行统计分析。结果　在舌鳞状细胞癌组织和癌旁正常舌黏膜组织中,Cystatin B的阳性表达率分别为72.0%(36/50)和36.0%(18/50),两者比较有统计学意义(P＜0.05);Cystatin C的阳性表达率分别为68.0%(34/50)和38.0%(19/50),两者比较有统计学意义(P<0.05)。Cystatin B与Cystatin C在不同病理分级中的表达强度分别有统计学意义(P＜0.05),与患者的年龄、性别及有无淋巴结转移均无关(P＞0.05)。结论　Cystatin B与Cystatin C在舌鳞状细胞癌的诊断及病理分级中具有一定的作用。     

Usefulness of contrast-enhanced CT in the evaluation of depth of invasion in oral tongue squamous cell carcinoma: comparison with MRI

Objectives

There is currently no standardized approach for assessing the depth of invasion (DOI) of oral tongue squamous cell carcinoma via diagnostic imaging. We investigated the usefulness of contrast-enhanced computed tomography (CECT) for estimating the pathological DOI of oral tongue squamous cell carcinoma by evaluating the correlation of pathological DOI with the DOIs on CECT and magnetic resonance imaging (MRI).

Methods

We retrospectively reviewed 21 of 139 patients who underwent radical surgery for primary oral tongue squamous cell carcinoma between 2009 and 2018. The 21 cases were evaluable, without dental artifacts on CECT. DOIs on CECT and MRI, and pathological DOI were measured.

Results

The median pathological DOI was 9 mm, that on CECT was 10.9 mm, that on T2-weighted MRI was 14.2 mm, and that on contrast-enhanced T1-weighted MRI was 13.1 mm. The DOIs on CECT and on MRI were larger than the pathological DOI (p?=?0.003 to <?0.001). The absolute value of the difference between pathological DOI and DOI on CECT was smaller than that between pathological DOI and DOI on MRI (p?=?0.01 and 0.003). DOIs on CECT and on MRI correlated with pathological DOI (r?=?0.74–0.66, all p?<?0.001). Spearman’s correlation coefficient between DOI on CECT and pathological DOI was greater than that between DOI on MRI and pathological DOI.

Conclusions

Compared to the DOI determined on an MRI scan, the DOI determined on a CECT scan correlated with and better approximated pathological DOI. Therefore, CECT can be useful for preoperative staging of patients with oral tongue squamous cell carcinoma.

     

RKIP在舌癌组织及转移淋巴结中的表达及意义

目的：探讨RKIP在舌癌组织及转移淋巴结中的表达及意义。方法：应用免疫组化法检测RKIP在60例舌癌组和癌旁组织表达情况,比较舌癌分化良好组和分化不良组RKIP表达,将舌癌淋巴结转移组和淋巴结无转移组RKIP表达进行比较。结果：舌癌组和癌旁组织相比,RKIP表达水平明显下降,两者之间有统计学差异（P〈0．05）。舌癌分化良好组RKIP表达高,分化不良组表达低,RK1P与舌癌病理分级之间,有相关关系（P〈0．05）。转移淋巴结RKIP表达低。结论：RKIP具有抑制舌癌转移的作用,其表达的上调能促进舌癌的分化,抑制舌癌的转移。     

EMMPRIN expression in tongue squamous cell carcinoma

Background:  Extracellular matrix metalloproteinase inducer (EMMPRIN) is identified as a tumor-cell membrane protein that stimulates matrix metalloproteinases (MMPs) production. Several studies have shown that higher EMMPRIN expression is associated with shorter survival time and correlated significantly with more advanced clinico-parameters of cancer. The aim of this study was to investigate the relationship between clinico-pathologic characteristics and EMMPRIN, and prognostic significance of EMMPRIN expression in human tongue squamous cell carcinoma.
Methods:  Extracellular MMP inducer expression was examined immunohistochemically on paraffin-embedded tissue specimens from 68 patients with tongue squamous cell carcinoma and who underwent radical surgeries from 1996 to 2006. The 68 patients were followed up from 1 to 119 months, with an average of 27.5 months. Nonparametric tests were performed for the comparison of EMMPRIN expression between two independent groups. Survival analysis was performed to find the prognostic significance of EMMPRIN expression.
Results:  We found that EMMPRIN expression in tongue squamous cell carcinoma is significantly higher than that in non-cancerous epithelium adjacent to carcinoma of tongue. In addition, EMMPRIN expression is significantly associated with tumor diameter and clinical stage in the samples, but did not correlate with gender, age, tumor metastasis, and pathological grade. Finally, survival analysis indicates that EMMPRIN overexpression correlates significantly with poor overall survival in the patient cohort.
Conclusion:  These results suggest that EMMPRIN might represent an attractive target for immunotherapeutic approaches in a subgroup of patients with tongue squamous cell carcinoma.     

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目的比较接受不同重建方式的临床颈部阴性(cN0)舌癌患者的术后生存质量。方法将2006年7月至2008年7月在广东省口腔医院颌面外科治疗的舌癌患者36例,按游离皮瓣重建、带蒂胸大肌皮瓣重建方式分为两组,每组患者18例。游离皮瓣重建组患者接受肩胛舌骨上颈淋巴清扫术,舌部缺损采用游离桡侧前臂皮瓣或游离股前外侧皮瓣修复;带蒂胸大肌皮瓣重建组患者接受改良根治性颈淋巴清扫术,舌部缺损采用带蒂胸大肌皮瓣修复。术后12个月,采用4版华盛顿大学生存质量问卷(UW-QOL)对两组患者的生存质量进行评价。结果游离皮瓣重建组在生存质量总分及肩功能、活动、语音、吞咽分项目上得分均优于胸大肌皮瓣重建组。结论对于cN0舌癌患者,采用肩胛舌骨上颈淋巴清扫术和游离皮瓣重建能显著提高患者的术后生存质量。     

cN0早期舌体鳞癌的颈部处理探讨

目的 通过对临床早期舌体鳞癌患者的回顾研究,探讨预防性颈淋巴结清扫和严密观察2种治疗方式的合理应用.方法 收集132例cN0早期舌体鳞癌病例,根据颈部处理方案分为颈清组(71例)和观察组(61例),统计分析临床、病理和随访资料.结果 颈清组和观察组的3年生存率分别为87.3％、83.4％.颈清组T1、T2病例的3年生存...