口腔鳞癌颈部淋巴结隐匿性转移的临床病理学特点及其意义  

Clinicopathological characteristics and significance of cervical lymph nodes occult metastasis in oral squamous cell carcinoma

作　　者：胡馨元 闫伟军[2] 闫嘉群[1] 毕良佳[3] Hu Xinyuan;Yan Weijun;Yan Jiaqun;Bi Liangjia(Third Affiliated Hospital of Harbin Medical University,Heilongjiang Harbin 150086,China;Oral Affiliated Hospital of Harbin Medical University,Heilongjiang Harbin 150010,China;Fourth Affiliated Hospital of Harbin Medical University,Heilongjiang Harbin 150010,China)

机构地区：[1]哈尔滨医科大学附属第三医院,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属口腔医院,黑龙江哈尔滨150010 [3]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150010

出　　处：《现代肿瘤医学》2019年第16期2844-2848,共5页Journal of Modern Oncology

基　　金：黑龙江省卫生健康委科研课题(编号:2018030)

摘　　要：目的:探讨口腔鳞癌颈部淋巴结隐匿性转移的临床病理学特点及其临床意义。方法:对168例口腔鳞癌未探及颈淋巴结转移的患者的临床病理学因素与颈淋巴结转移的关系进行回顾性研究,并依据临床触诊及影像学结果将淋巴结分为三组,并对比各组淋巴结转移与临床病理学特点的相关性。结果:cN0期口腔鳞癌患者颈部淋巴结隐匿性转移与年龄、原发灶的大小、病理分化及生长方式存在统计学差异(P<0.05);牙龈癌及颊黏膜癌原发肿瘤越大发生颈部淋巴结隐匿性转移的几率越高。临床影像学未探及肿大淋巴结组其淋巴结阳性率与原发肿瘤大小及肿瘤生长方式密切相关(P<0.05),影像学肿大淋巴结小于1cm组其颈部淋巴结阳性率与原发肿瘤病理分化程度密切相关。结论:口腔鳞癌颈部淋巴结的隐匿性转移是影响患者预后的重要因素,因此,明确隐匿性转移的危险因素,对选择合理的治疗方案、判断疗效及评估预后有重要作用。Objective:To explore the clinicopathological features and significance of cervical lymph nodes occult metastasis in oral squamous cell carcinoma.Methods:Clinicopathological factors of 168 patients with undetected cervical lymph node metastasis in oral squamous cell carcinoma were retrospectively studied.The lymph nodes were divided into three groups according to the results of clinical palpation and imaging,and the relationship between lymph node metastasis and clinicopathological characteristics was compared.Results:The occult metastasis rate of cervical lymph nodes in patients with cN 0 oral squamous cell carcinoma had a significant difference in the age,size of primary tumor,grade and growth mode(P<0.05).The greater size of the primary tumors to gingival carcinoma and buccal mucosal carcinoma was,the higher metastasis rate of occult cervical lymph node was.The positive rate of lymph nodes in the undetected and enlarged lymph nodes group was closely related to the size of the primary tumor and the growth pattern of the tumor,and lymph nodes less than 1 cm was closely related to the pathological differentiation degree of the primary tumor(P<0.05).Conclusion:Cervical lymph nodes occult metastasis in oral squamous cell carcinoma is an important factor affecting prognosis.To identify the risk factors of occult metastasis plays an important role in the selection of appropriate treatment options and evaluation of the efficacy and prognosis.

关 键 词：口腔鳞癌 颈部淋巴结 隐匿性转移 临床病理学特点 

分 类 号：R739.8[医药卫生—肿瘤]