舌鳞状细胞癌安全切缘宽度的定量研究  

Quantitative study on the width of surgical margins of tongue squamous cell carcinoma

作　　者：严国鑫[1] 孙坚[2] 

机构地区：[1]无锡市第二人民医院口腔科,214002 [2]上海市第九人民医院口腔颌面外科

出　　处：《实用口腔医学杂志》2007年第5期621-624,共4页Journal of Practical Stomatology

摘　　要：目的:分析舌鳞癌的扩散距离与相关病理参数间的关系,为临床上对不同个体舌鳞癌的安全切缘宽度的确定提供理论依据。方法:将30例舌鳞癌标本行定位及固定后,按冠状位每隔3mm作连续切片,常规HE染色。运用Photoshop软件对切片图像进行锐化处理,确定肿瘤边缘,测量扩散距离,按相关病理参数分组进行统计学分析。结果:病理Ⅰ级与Ⅱ、Ⅲ级的2组舌鳞癌的扩散距离之间无显著性差异(P>0.05);T1、T2与T3、T4的2组舌鳞癌的扩散距离之间无显著性差异(P>0.05)。肿瘤厚度小于5mm及大于5mm的2组舌鳞癌的扩散距离之间有显著性差异(P<0.05);小于5mm的扩散距离在4mm以内,大于5mm的扩散距离在9.5mm以内。浸润方式为Ⅰ型与Ⅱ型及Ⅲ、Ⅳ型的3组舌鳞癌的扩散距离之间有显著性差异(P<0.05);Ⅰ型的扩散距离在2.5mm以内,Ⅱ型的扩散距离在7mm以内,Ⅲ、Ⅳ型的扩散距离在9.5mm以内。结论:舌鳞癌的扩散距离与肿瘤的T分期及病理分级无明显关系;舌鳞癌的厚度与肿瘤扩散距离关系密切;同时发现肿瘤的浸润方式与肿瘤扩散距离关系密切,对不同个体舌鳞癌安全切缘宽度的确定具有临床意义。Objective： To analyze the relationship between the diffusion distance of tongue squamous cell carcinoma （TSCC） and relevant pathological parameters to get the theoretical data for the determination of width of surgical margins for individual TSCC. Methods： 30 samples of TSCC were localized and fixed. Continuous sections were cut at the coronal position every 3 mm and stained with HE. The edge of tumor was determined by Photoshop analysis. The distance of partial diffusion was measured. Furthermore, the relevant pathological parameters of TSCC were evaluated. Results：As for the diffusion distance of TSCC, there was no significant difference between the 2 groups （ pathologically grade Ⅰ and grade Ⅱ ＆Ⅲ ） （ P 〉 0.05 ） ; also no significant difference between the group TI ＆T2 and T3＆T4 （ P 〉0.05 ） ; there was a significant difference between the groups, in which the thickness of tumor was less than 5 mm, and the other one, in which the thickness was greater than 5 mm （P 〈 0.05 ）. For the group in which the thickness of tumor was less than 5 mm, the diffusion distance was less than 4 mm ; and for the other one in which the thickness of tumor was more than 5 mm, the diffusion distance was less than 9.5 mm. There were significant differences in diffusion distance between the 3 groups （ pattern of invasion Type Ⅰ , Type Ⅱ , and Type Ⅲ ＆ Ⅳ ） （ P 〈 0. 05）. The diffusion distance of Type Ⅰ was less than 2.5 ram, that of Type Ⅱ was less than 7 mm, and that of Type Ⅲ ＆ Ⅳ was less than 9.5 mm. Conclusion ： There is no significant correlation between diffusion distance to T stages and pathological grading of TSCC, while the diffusion distance of TSCC is closely related to its thickness and pattern of invasion. This conclusion might be useful for the correct estimation of the surgical margins of TSCC.

关 键 词：舌鳞状细胞癌(TSCC) 肿瘤厚度 浸润方式 安全切缘 

分 类 号：R739.8[医药卫生—肿瘤]