口腔鳞状细胞癌cN+颈部处理的研究进展  

Research progress on the neck management of oral squamous cell carcinoma with clinically nodepositive neck

作　　者：陈震 章文博 彭歆[1] CHEN Zhen;ZHANG Wenbo;PENG Xin(Department of Oral And Maxillofacial Surgery,Peking University School and Hospital of Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院,北京100081

出　　处：《口腔疾病防治》2021年第11期776-781,共6页Journal of Prevention and Treatment for Stomatological Diseases

摘　　要：口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)是口腔颌面部最常见的恶性肿瘤,颈部淋巴结转移是OSCC重要的生物学行为,也是影响患者预后的主要因素。颈淋巴清扫术作为颈部处理最常用的手术方式,术式的合理选择非常重要。目前的观点认为:对于临床评估有颈部淋巴结转移(clinically nodepositive neck,cN+)的患者,术式可采用根治性或改良根治性颈淋巴清扫术;而对于临床评估颈部无明显转移(cN0)的患者,术式可采用择区性颈淋巴清扫术。近年来,择区性颈淋巴清扫术被越来越多的推广应用,其适应证也由cN0向cN+逐渐扩大。然而,对于OSCC cN+患者是否也可以采用择区性颈淋巴清扫术,目前仍未达成共识。本文将近年来关于OSCC cN+颈部处理的临床研究进行文献综述,分析不同的颈淋巴清扫术对cN+OSCC预后的影响,总结OSCC cN+颈部的治疗原则。Oral squamous cell carcinoma(OSCC)is the most common malignant tumor in the oral and maxillofacial regions.Cervical lymph node metastasis is not only an important biological behavior of oral cancer but also an important factor affecting the prognosis of oral cancer patients.As neck dissection is the most commonly used method of neck management,the appropriate choice of surgical procedure is very important.The current view is that radical neck dissection or modified radical neck dissection can be used for patients with clinically nodepositive neck(cN+),while selective neck dissection can be used for patients with clinically nodenegative neck(cN0).In recent years,selective neck dissection has been increasingly popularized and applied.Its implications are also gradually expanding from cN0 to cN+.However,there is still no consensus on whether selective neck dissection can also be used in patients with cN+necks.This article reviews the clinical studies on the neck management of cN+OSCC patients in recent years,analyzes the effects of different neck dissections on the prognosis of cN+OSCC patients,and summarizes the treatment principles of neck management.

关 键 词：择区性颈淋巴清扫术 口腔鳞状细胞癌 颈淋巴结转移 术后并发症 生存质量 预后 辅助治疗 治疗原则 

分 类 号：R78[医药卫生—口腔医学]