颊黏膜鳞癌cN_0患者的颈部处理  

The Neck Treatment of cN_0 Patients with Squamous Cell Carcinoma of Buccal Mucosa

作　　者：吴正华[1] 黄欣[1] 康非吾[1] 温玉明[1] 王昌美[1] 

机构地区：[1]四川大学华西口腔医院口腔颌面外科,610041

出　　处：《华西口腔医学杂志》2003年第3期194-196,共3页West China Journal of Stomatology

摘　　要：目的　探讨颊黏膜鳞癌cN0 患者的颈部处理原则。方法　对四川大学华西口腔医院颌面外科1 980～ 2 0 0 0年收治的 1 0 1例颊黏膜鳞癌cN0 患者进行回顾性研究。所有患者均行原发灶切除加同期或二期颈清扫术 ,有的患者还兼行化疗、放疗。术后淋巴结作病理学检查 ,随访 3年以上。结果　 1 0 1例颊黏膜鳞癌cN0 患者中有 1 7例发生颈淋巴结转移 ,淋巴结隐匿性转移 (OM)率为 1 6 83% ,且随临床T分期的增高而增高 ,T3和T4 期的隐匿性转移率分别为 1 8 1 8%和 5 2 0 0 % ;转移淋巴结主要分布于颌下淋巴结组 (4 1 1 8% )和颈深上淋巴结组(2 9 4 1 % )。结论　颊黏膜鳞癌颈部隐匿性转移率较高 ,对T3,4 期的cN0 颊黏膜鳞癌患者应考虑行选择性同期全颈清扫术。Objective\ The purpose of this study was to discuss the principle in neck treatment of cN\-0 patients with squamous cell carcinoma of buccal mucosa.Methods\ 101 patients of squamous cell carcinoma of buccal mucosa at the stage of cN\-0, who had hospitalized in West China College of Stomatology, Sichuan University from 1980 to 2000, were investigated retrospectively. All the patients received a comprehensive therapy consisting of surgical procedures combined with chemotherapy and radiotherapy. The combining radical therapy of buccal, mandible and neck was the main surgical method. Lymph nodes were cleared after operation and examined by pathological method. The patients had been followed up for more than 3 years.Results\ 17 patients had lymph nodes metastasis, the occult metastasis (OM) rate was 16.83%. It increased in the high stage of original lesion, the OM rate of T\-3 and T\-4 was 18 18% and 52.00%, respectively. The metastasized lymph nodes were mainly located in submandible and superior deep cervix lymph nodes, their respective metastasis rate was 41 18% and 29 41%.Conclusion\ The rate of occult metastasis of squamous cell carcinoma of buccal mucosa is high, and then we should adopt actively selective neck dissection for the cN\-0 patients of squamous cell carcinoma of buccal mucosa.\;

关 键 词：颊黏膜鳞癌 cN0患者 颈部处理 隐匿性转移 

分 类 号：R739.8[医药卫生—肿瘤]