舌鳞状细胞癌厚度与区域淋巴结转移的超声研究  

Ultrasonographic study on the relationship between the thickness of squamous cell carcinoma of tongue and cervical lymph node metastasis

作　　者：周辉红[1] 徐秋华[1] 胡永杰[2] 詹维伟[3] 燕山[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院超声诊断科,上海200011 [2]上海交通大学医学院附属第九人民医院口腔颌面外科,上海200011 [3]上海交通大学医学院附属瑞金医院超声诊断科,上海200025

出　　处：《上海口腔医学》2008年第5期465-470,共6页Shanghai Journal of Stomatology

摘　　要：目的:从超声角度探讨舌癌肿瘤厚度与颈部淋巴结转移的关系。方法:使用口腔内超声探头检查测量37例原发性舌癌患者的肿瘤厚度,同时检查其颈淋巴结情况,记录各区淋巴结的数量、大小及内部回声,观察淋巴结的血流信号并判断其性质。使用SAS6.1软件包对数据进行χ2检验、非参数检验和Logistic回归分析。结果:术前超声测量的肿瘤厚度与病理标本测量的肿瘤厚度作非参数Wilcox秩和检验(P=0.2013),2种方法所测量的肿瘤厚度的均数差异无统计学意义。将肿瘤厚度与颈淋巴结转移作非参数检验(Spearmanr=0.6824,P<0.01),超声测量的肿瘤厚度与颈淋巴结转移情况呈正相关,Logistic回归分析显示,随着厚度的增加,淋巴结转移的风险也增大。结论:应用超声正确检测舌癌的肿瘤厚度及颈部转移的淋巴结,可以在术前对舌癌的临床分期进行更好地评估,为手术医师制订方案提供确切的依据。PURPOSE： This study aims to investigate the correlation between the thickness of the tongue carcinoma and cervical lymph node metastasis obtained with ultrasonography. METHODS： The tumor thickness of 37 primary tongue cancers were measured in the sonogram by the intraoral uhrasonography. The cervical lymph nodes were scanned, and the number, size, internal echo, and blood stream were measured to evaluate the nature. SAS6.1 software package was used for Chi-square test, non-parametric test and Logistic regression. RESULTS： The tumor thickness measured before operation with ultrasonography and after operation from pathological sections was subjected to non-parameter Wilcox rank-sum test, P=0.2013, indicating that there was no significant difference between the mean thickness obtained from the two modalities. The tumor thickness and cervical lymph node metastasis were subjected to non-parameter rank correlation test, the Spearman r=0.6824,P〈0.01, indicating that there were a positive correlation between the tumor thickness measured by ultrasonography scan and cervical lymph node metastasis. Logistic regression analysis also showed that the risk of metastasis of the neck lymph nodes increased with the increased thickness of the tumors. CONCLUSIONS： The accuracy and sensitiveness of uhrasonography in measuring the tumor thickness and detection of cervical lymph metastases make it a promising pre-operative tool in staging the cancer and optimizing the treatment plan for the surgeons.

关 键 词：舌 鳞状细胞癌 肿瘤厚度 颈淋巴结 转移 

分 类 号：R739.8[医药卫生—肿瘤]