口腔鳞癌颈淋巴结微转移的检测及临床意义

Micrometastasis in oral squamous cell carcinoma: incidence and clinical implication

目的:探讨口腔鳞癌颈淋巴结微转移的发生率及临床意义。方法:对46例口腔鳞癌常规病理学检查阴性的颈淋巴结标本作连续切片,并采用免疫组化和流式细胞技术(FCM)检测微转移,以阳性淋巴结作为对照。随访5a。结果:46例口腔鳞癌患者的276枚常规病理检查阴性的颈淋巴结,免疫组化检测有5例8枚淋巴结有微转移(10.87%,5/46)。FCM检测200枚淋巴结,原8枚免疫组化检测阳性的淋巴结全部为阳性,阳性数为0.49%～6.06%。5例淋巴结微转移患者,4例复发。结论:免疫组化和流式细胞技术可提高口腔鳞癌颈淋巴结微转移发现的机率,对术后辅助治疗和预后评估具有一定的指导意义。

PURPOSE: To investigate the incidence and clinical significance of lymph node micrometastases in oral squamous cell carcinoma. METHODS: Micrometastases for 276 histological metastasis-negative nodes in 46 cases were detected by immunohistochemistry and FCM. All cases were followed up for 5 years. RESULTS: Of 276 histological metastasis-negative lymph nodes in 46 cases,8 micrometastatic LNs(10.87%,5/46) were detected based on CK expression in 5 cases. 0f 200 histological metastasis-negative lymph nodes , 8 micrometastatic LNs which were positive based on CK expression by immunohistochemistry were found by FCM as well. The amount of positive cells was 0.49% to 6.06%. The recurrence happened in 4 of 5 cases with micrometastasis within 5 years. CONCLUSION: The detection of immunohistochemistry and FCM may increase findings of lymph node micrometastases in patients with oral squamous cell carcinoma. This is very important for patients with micrometastases receiving adjuvant therapy and prognostic evaluation after operation.