联合根治术在口腔癌的临床应用研究  

Retrospecive clinical study the appliction of union radical correction in oral carcinoma.

作　　者：童庆春 金志勤[2] 徐嘉莉 

机构地区：[1]上海市嘉定区中心医院口腔科,上海201800 [2]青岛大学医学院附属医院口腔科,山东青岛266000

出　　处：《临床和实验医学杂志》2007年第8期20-21,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨根治性颈淋巴清扫术（RND）、功能性颈淋巴清扫术（FND）和选择性颈淋巴清扫术（SND）在口腔癌的临床疗效及其与病理因素之间的关系。方法原发灶为临床或病理证实的淋巴结转移病例;对于原发灶超过中线的T4病例或对侧有转移的病例实施RND;对T1-T3、临床淋巴结为N0的口腔癌患者实施FND;原发灶为T1-T2、临床淋巴结为N0,原发灶为T2-T3、临床淋巴结为N1或Nx（无法评估有无区域性淋巴结）的口腔癌患者实施SND。观察术后并发症的发生率、复发率,并探讨复发情况与病理因素的关系。结果RND、FND和SND术后的淋巴结转移率和复发率,三者相比差异无显著性（P〉0.05）;口腔癌随着分化程度的增高,而显示渐增高的转移率（P〈0.05）。结论FND和SND可作为RND的替代手术方式,肿瘤的分化程度与转移能力呈负相关关系。Objective To investigate the clinical results of the radical neck dissection （RND）, functional neck dissection （ FND）, selective neck dissection （SND） for oral carcinoma and the relationship between lymph node metastases and pathologic factors. Methods RND was performed in patients with primary tumors of T4 beyond middle line; FND was performed in patients with primary tumors of T1 - T3 and lymph node of NO ; SND was performed in patients with primary tumors of T1 - T2 and lymph node of NO.. Postoperative complications and recurrent rate were compared and the relationship between lymph node metastasis and pathologic factors was analysed.. Results There were no significant differences in the lymph node metastatic rate and relapse rate in the 3 groups （ P 〉 0.05 ）. Metastatic rate of oral carcinoma increased with the increase in differentiation degree （ P 〈 0.05 ）. Conclusion FND and SND can replace RND for oral carcinoma and there is negative correlation between differentiation degree and metastasis.

关 键 词：口腔癌 根治性颈淋巴清扫术 功能性颈淋巴清扫术 选择性颈淋巴清扫术 转移 复发 

分 类 号：R739.8[医药卫生—肿瘤]