口腔癌的临床病理特征与预后

Clinicopathological parameters as prognostic role in oral cancer

口腔鳞状细胞癌占口腔恶性肿瘤的90%以上,恶性程度较高,寻找与其预后相关的因素有利于肿瘤的治疗和预后评估。目前的研究发现,一些临床病理指标在预测口腔癌的预后中具有一定价值。在与肿瘤大小有关的因素中,肿瘤厚度(侵袭深度)是唯一具有独立预后价值的指标;对肿瘤侵犯前沿进行组织学分级,在预测淋巴结转移、局部复发、生存率方面的价值显著高于传统的对整个肿瘤的组织学分级;肿瘤手术切缘状况与肿瘤复发、患者生存率相关,但安全手术切缘的界定标准尚有待统一;肿瘤是否有淋巴结转移、淋巴结转移程度特别是肿瘤的淋巴结包膜外浸润在预测肿瘤复发、远处转移、生存率方面具有重要意义。

Oral squamous cell carcinoma accounts for more than 90% of all oral malignant tumors. Since the high grade malignancy of the tumor, prognostic studies are strongly needed for assistance of the tumor treatment and prognostic assessment. Recent reports from investigators indicates that some clinicopathological parameters could be possible predictors in oral cancer. Tumor thickness is the only size criterion to have independent predictive value. Invasive front grading is more valuable in predicting nodal metastasis, local recurrence and survival than conventional Broders＇/WHO histologic grading system. Status of the resection margins is correlated to tumor recurrence and survival, however, the consensus on the criterion of secure resection margins need to be reached. The presence and extent of lymph node metastasis, especially the extracapsular spread, has been recognized as strong predictors in regional recurrence, distant metastasis and survival.