口腔癌对侧颈淋巴结转移的高危因素分析

High risk factors of contralateral neck lymph node metastasis in oral squamous cell carcinoma

目的：分析影响口腔癌患者发生对侧颈淋巴结转移的临床病理因素.方法：收集2010年6月～2011年6月间217例中发生对侧颈淋巴结转移的口腔癌病历资料13例,对其临床病理特点进行分析.结果：口腔癌对侧颈淋巴结转移多发于年轻患者,部位以舌、口底常见,并与临床分期、病理分级、同侧颈淋巴转移等因素密切相关,其协同作用可能加快其转移.结论：在≤45岁、肿瘤范围越过中线、侵及口底、≥T3期、低分化鳞癌、同侧颈淋巴结转移等因素中若出现两项或以上者,则有必要考虑同期行对侧颈淋巴结清扫术,以提高患者治愈率和生存率.

Objective：To analysis clinical pathological factors affecting contralateral neck lymph node metastasis in o- ral squamous cell carcinoma （OSCC）. Method： Collecting 13 cases of OSCC patients with contralateral neck lymph node metastasis from a total of 217 case from june 2010 to june 2011 to study the contralateral neck lymph node metastasi-related clinical pathological factors. Result： OSCC patients with contralateral neck lymph node metastasis offen happened in younger patients and the most common primary site are located in tongue and the mouth floor; the clinical stage,histological type, ip- silateral clinically lymph node- positive were closely related with those patients,The synergistic effect of these factors may accelerate the metastasis. Conclusion： To improve the cure and survival rates, prophylactic contralateral neck dissection is suggested for patients with those factors： ≤ 45 years, tumor crossing of the midline, floor of mouth involvement, tumor stage ≥ T3, poorly differentiated tumors, ipsilateral clinically lymph node-positive which simultaneously including two or more factors above.