选择性颈淋巴清扫术及其适应证的评价

作者通过对３８２例行颈淋巴清扫术的口腔癌患者的回顾性研究，对选择性（即预防性）颈清扫术及其适应证进行评估。本研究重点分析了各种相关因素与颈淋巴结转移的关系。结果表明：各种口腔癌的颈淋巴结总转移率为４４％（１６７／３８２）。而在术前未扪及肿大淋巴结者即隐匿性转移率为２３％（１９／８４）。颈淋巴转移的发生频率与原发灶的大小、部位、肿瘤细胞的分化程度和肿瘤类型等密切相关。特别是颈淋巴结的状况是评估颈部转移的重要信息。本研究强调对原发灶及颈淋巴的仔细检查和综合分析，有助于更准确判断是否有颈淋巴转移及是否应行ＥＮＤ。

Evaluation of elective(prophylactic) neck dissection and its indications

The purpose of this study is to assess the value of elective neck dissection(END) and its indications by retrospective analysis of 382 malignant carcinomas of oral cavity cases underwent neck dissection. This study mainly analysed the relationship between the correlative factors and metastasis of neck in carcinomas of oral cavity.The result showed that: on histopathologic examination of surgical specimens the total rate of cervical lymph node metastasis with malignant tumor of oral cavity was 44 % (167/382). But no palpable lymph - node preoperative cases the rate of occult metastasis was 23% (19/84). According to this study the incidence of neck metastasis was closely related to the size, location, pathological differentiation and type of the primary lesion,and espesially, the condition of the lymph - nodes was important information to assess cervical metastasis. This review emphasises that careful clinical examination of primary lesion and lymph - node of neck and compositive analysis of all findings can help to more accurately determine the lymph- node metastasis and indications of END.