口腔鳞癌颈部转移淋巴结的包膜外扩散与术后复发的关系探讨

Relationship between extracapsular spread of cervical metastatic lymph node and cervical recurrence in oral cancer patients

目的探讨口腔鳞癌颈部转移淋巴结的包膜外扩散与术后复发的关系。方法 74例口腔鳞癌经术后病理证实均有颈部淋巴结转移,按照有、无包膜外扩散将患者分为两组,回顾临床和病理资料,随访患者术后复发的情况,分析包膜外扩散和其他相关临床病理因素对术后复发的影响。结果无包膜外扩散和有包膜外扩散两组患者的术后总复发率分别为47.6%和75.0%,颈部复发率分别为9.5%和46.9%,差异均具有统计学意义(P<0.001)。多因素分析显示,包膜外扩散是术后颈部复发的独立预后因素,但它不是影响总复发率的独立因素。结论包膜外扩散与口腔鳞癌术后复发明显相关,是颈部复发的重要危险因素。

Objective To investigate the relationship between extracapsular spread （ECS）of cervical metastatic lymph node and the recurrence in patients with oral squamous cell carcinoma （ OSCC ）. Methods The medical records of 74 OSCC patients with histologically confirmed cervical lymph node metastasis were reviewed. They were divided into 2 groups, ECS positive （ ECS ＋ ） and ECS negative （ECS-）. The treatment results were followed up. Statistical analysis, with chi-square test, and multiple logistic regression was conducted. Results The overall recurrence rates for pN ＋/ECS- and pN ＋/ECS ＋ patients were 47. 6% and 75.0%, respectively, and the cervical recurrence rates for pN ＋/ECS- and pN ＋/ECS ＋ patients were 9. 5% and 46. 9% , respectively（ P 〈 0. 001 ）. Multivariate analysis showed that ECS was one of the independent prognosis factors for cervical recurrence. Conclusions Extracapsular spread significantly increased both overall and cervical recurrence rates, and ESC may be a prognosis factor for OSCC patients.