101例上牙龈癌颈部淋巴结转移及预后分析  

Analysis of characteristics and prognosis of cervical lymph node metastasis in 101 patients with oral maxillary squamous cell carcinoma

作　　者：张煦[1] 周文凯 任政虎 林承重 刘喆麒 杨嵘[1] 季彤[1] 曹巍[1] Xu Zhang;Wenkai Zhou;Zhenghu Ren;Chengzhong Lin;Zheqi Liu;Rong Yang;Tong Ji;Wei Cao(Department of Oral and Maxillofacial&Head and Neck Oncology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Second Dental Clinic,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科,上海市200011 [2]上海交通大学口腔医学院 [3]上海交通大学医学院附属第九人民医院口腔第二门诊部

出　　处：《中国肿瘤临床》2020年第20期1051-1054,共4页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金面上项目资助(编号:81672745)资助。

摘　　要：目的:探讨上牙龈癌颈部淋巴结转移特点并分析其影响因素及预后。方法:回顾性分析上海交通大学医学院附属第九人民医院2015年1月至2018年12月收治的101例上牙龈癌患者的临床及随访资料。结果:101例患者总颈淋巴结转移率为28.7%,中位生存时间为(48.40±2.73)个月。累及龈颊沟患者的颈部淋巴结转移率为38.6%,未累及为6.5%,差异具有统计学意义(P<0.001)。肿瘤累及软腭、窦腔和发生颈部淋巴结转移对患者的预后有显著不良影响(P<0.05)。结论:上牙龈癌具有较高的颈部淋巴结转移率,尤其对于累及龈颊沟的患者应行同期预防性颈淋巴结清扫,肿瘤累及软腭、窦腔和发生颈部淋巴结转移可作为上牙龈癌预后的预测因素。Objective:To investigate characteristics and prognostic factors of cervical lymph node metastasis in patients with oral maxillary squamous cell carcinoma.Methods:Clinical and follow-up data of 101 patients with oral maxillary squamous cell carcinoma admitted to Shanghai Ninth People's Hospital between January 2015 and December 2018 were retrospectively analyzed.Results:The cervical lymph node metastasis rate was 28.7%.The median survival time was(48.40±2.76)months.Multi-factor analysis revealed that the cervical lymph node metastasis rate for cases in which the tumor invaded the buccal groove was 38.6%,which was significantly different from that for cases in which the tumor did not invade the buccal groove(P<0.001).COX analysis showed that soft palate and midline invasion predicted lower survival time.Conclusions:Patients with oral maxillary squamous cell carcinoma have a high cervical lymph node metastasis rate,especially for cases in which the buccal groove is invaded.For such cases,preventive neck dissection is necessary.Soft palate invasion,maxillary sinus invasion,and cervical lymph node metastasis can be predictors of oral maxillary squamous cell carcinoma.

关 键 词：头颈鳞状细胞癌 淋巴结转移 上颌肿瘤 生存 预后 

分 类 号：R739.8[医药卫生—肿瘤]