T_1 、T_2 No舌活动部鳞癌隐匿性颈淋巴结转移的规律及治疗  

Rule of occult neck metastasis and its treatment in the T_1、T_2 No tongue squamous carcinomas

作　　者：赵华[1] 曾宗渊[1] 陈福进[1] 许光普[1] 郭朱明[1] 张诠[1] 

机构地区：[1]中山大学肿瘤防治中心头颈科,广州510060

出　　处：《陕西肿瘤医学》2003年第1期24-26,共3页ShanXi Oncology Medicine

摘　　要：目的　探讨T1、T2 舌鳞癌隐匿性颈淋巴结转移的分布特点和治疗方式。方法　回顾性分析中山大学肿瘤医院 133例T1、T2 No舌活动部鳞癌病例 ,根据隐匿性颈淋巴结转移分布探讨早期舌鳞癌的转移规律 ;分析选择性全颈淋巴结清扫术和区域性颈淋巴清扫术的预后。结果　 133例早期舌鳞癌中 32例发生隐匿性颈淋巴结转移 ,转移率是 2 4.1% ;隐匿性颈淋巴结主要分布在levelⅡ( 5 2 .6 % )、其次是levelⅠ( 36 .8% )、再次是levelⅢ ( 7.9% )、以及对侧levelⅠ( 2 .6 % ) ,levelⅣ和Ⅴ无隐匿性转移淋巴结存在。本组选择性全颈清扫组、区域性颈清扫组 (levelⅠ～Ⅲ)和未颈清扫组的 5年生存率分别是 83 .5 %、76 .9%和 71.0 % ,三组两两间无统计学差异 (P >0 .0 5 ) ;T1舌鳞癌中颈淋巴结清扫组与未行颈淋巴结清扫组的生存率分别为 87.6 %和 80 .0 % ,两组间无统计学差异 (P >0 .0 5 ) ;T2 舌鳞癌全颈清扫组、区域性清扫组和未行颈清扫组患者的 5年生存率为 80 .6 %、74.1%和 6 1.1% ,全颈清扫和区域性清扫组间存在着统计学差异 (P <0 .0 5 )。所有患者的 5年生存率是 78.2 %。结论　T1、T2 No舌鳞癌隐匿性颈淋巴结转移主要分布在levelⅠ、Ⅱ和Ⅲ ;T1舌鳞癌颈部以观察为主 ,T2 宜施行levelⅠ、Ⅱ和Ⅲ(上半颈 )选择性颈?Objective To study the rule of occult neck metastasis and investigate the effect of neck dissection in early stage squamous cell carcinoma ofthe tongue.Methods 133 cases with T1No?T2No squamous cell carcinoma of the tongue was reviewed.keywords We explored the distributive of occult neck lymph node metastasis and the value ofreviewed.electiveneckdissectioninearlytonguecancer.ResultsTherewere 32caseswithnecklymphnodemetastasisin 133casestonguecancer.TheoccultnecklymphnodemetastasiswasfoundmainlyinlevelⅡ( 5 2 .6 % ) ,secondlyinlevelⅠ( 36 .8% ) ,thirdlyinlevelⅢ( 7.9% ) ,oppositelevelⅠ( 2 .6 % )andnoinlevelⅣandⅤ ,thetotalmetastasisratewas2 4.1% .Therewerenosignificantinelectiveneckdissection ,electiveselectivelevelⅠ～ⅢneckdissectionandnoneckdissectiongroupinT2 NotonguecancerandT1No(P >0 .0 5 ) .The 5 - yearsurvivalrateswere 80 .6 %forneckdis section,74.1%forselectivelevelⅠ～Ⅲneckdessectionand 6 1.1%fornoneckdissectioninT2 Notonguecancer,thereisstatisticalsignificant (P <0 .0 5 )betweenneckdissectiongroup/orselectivelevelⅠ～Ⅲneckdissectionandnoneckdissection .The 5 - yearsurvivalrateswas 78.2 %inallcases.ConclusionTheoccultnecklymphnodemetasta sisofT1、T2 NosquamouscellcarcinomaofthetonguemainlydistributeinlevelⅠ,Ⅱ ,Ⅲ ;ThepatientswithT2 NotonguecancershouldbeperformednecklymphnodedissectioninlevelⅠ ,ⅡandⅢ(supra -half-neck) .ItisnecessarytoobservethenecklymphnodeinT1Notonguecarcimoma.

关 键 词：舌肿瘤 癌 鳞状细胞 早期 淋巴结 转移 治疗 

分 类 号：R739.860.5[医药卫生—肿瘤]