100例cNO舌癌患者隐匿性淋巴结转移部位及相关因素分析

目的分析cN0舌癌患者隐匿性淋巴结转移特点及临床病理因素对隐匿性转移的影响,为选择性颈清扫提供临床依据。方法收集100例cN0舌癌患者资料,分析其隐匿性颈淋巴结转移的特点及原发灶的直径、T分级、浸润深度、生长方式、病理分级、分化程度等对隐匿性转移的影响。结果 100例cN0舌癌隐匿性颈淋巴结转移率为22%,最常见的转移部位是同侧的Ⅱ区,占总转移部位的51.61%（16/31）,其次分别为同侧Ⅰ和Ⅲ区,87.10%（27/31）的隐匿性转移位于以上三个区域。另外,舌癌的直径与隐匿性转移无明显关系（P〉0.05）,而浸润深度、生长方式、病理分级,肿瘤分级和分化程度对其有显著性影响（P〈0.05）,且随着病理分级、分化程度、浸润深度递增,转移率有升高的趋势。结论同侧的Ⅰ、Ⅱ和Ⅲ区是cN0舌癌隐匿性颈淋巴结转移的常见区域,综合考虑原发灶的浸润深度、生长方式、病理分级和分化程度等临床病理因素,对较易发生隐匿性颈淋巴结转移的cN0舌癌患者可行选择性肩胛舌骨肌上清扫术。

Analysts of occult cervical lymph node metastasis and its related factors in 100 cNO tongue cancer patients

Objective To investigate the occult cervical lymph node metastasis and its influencing factors in tongue squamous cell carcinoma.Methods The data of 100 patients with occult cervical lymph node metastasis were retrospectively studied,including the size,TNM stage,patten of growth,pathological grade of primary lesion and cervical lymph node metastasis.Results The overall rate of occult cervical lymph node metastasis was 22%.Positive lymph node was most frequently found in levelⅡ(51.6%),followed by levelⅠand level Ⅲ.Occult cervical lymph node metastasis was not significantly related to tumor size and TNM stage(P>0.05),but related to patten of growth and pathological grade(P<0.05).Conclusion Occult cervical lymph node metastasis of tongue cancer occurred most frequently in levelⅠ,levelⅡand level Ⅲ.SOND should be choosed based on the size,TNM stage,patten of growth and pathological grade of the primary lesion.