口腔癌颈部转移淋巴结包膜外扩散的临床观察

Extracapsular spread of lymph node metastasis in patients with oral squamous cell carcinoma

目的观察口腔癌颈部转移淋巴结包膜外扩散的发生情况,并探讨包膜外扩散对预后的影响。方法选取术后病理证实有颈部淋巴结转移的口腔癌患者74例,回顾淋巴结的病理切片,观察包膜外扩散的发生率,随访术后复发和生存情况,并进行统计分析。结果74例患者中,有32例(43.2%)发现有包膜外扩散,无包膜外扩散和有包膜外扩散两组患者的术后总体复发率分别为47.6%和75.0%,颈部复发率分别为9.5%和46.9%,术后2年生存率分别为67.7%和37.0%。结论口腔癌颈部淋巴结的包膜外扩散发生率较高,包膜外扩散与术后复发尤其是颈部复发明显相关,并且显著影响生存率。

Objective To assess the prevalence of extracapsular spread （ECS） of lymph node metastasis in patients with oral squamous cell carcinoma （OSCC）, and to investigate the significance of ECS in predicting the outcomes. Methods The H＆E staining lymph ＂nodes sections of 74 OSCC patients were reviewed to estimate the prevalence of ECS. Clinical follow - up of the patients was performed. Results Of the 74 pathologically node - positive （ pN ＋ ） patients, 32 （43.2%） were ECS positive （ECS ＋ ）. The overall recurrence rates for pN ＋/ECS - and pN ＋/ECS ＋ patients were 47.6% and 75.0%, respectively, and the regional recurrence rates for pN ＋/ECS - and pN ＋/ECS ＋ patients were 9.5% and 46.9%, respeetively. The 2 - year overall survival rate for pN ＋/ECS - patients was 67.7% and 37.0% for pN ＋/ECS ＋ patients. Condusion There was a high prevalence of ECS in OSCC patients. ECS was strongly related with both overall and regional recurrence rates. The survival rates were significantly decreased in patients with ECS. Therefore, ECS should he a prognosis factor for OSCC patients.