口腔颌面部鳞癌原发灶部位对颈淋巴结转移区域的影响

Effect of primary site for oral and maxillary squamous cell carcinoma on location of neck node metastasis

目的：分析口腔颌面部不同原发部位鳞癌颈部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区转移倾向性。方法：回顾性收集北京大学口腔医院口腔颌面外科2000年1月至2011年12月1233例（1340侧）同期行颈淋巴清扫术及原发灶切除的口腔颌面部鳞状细胞癌患者资料，记录颈部淋巴结转移部位，分别计算不同原发部位鳞癌颈部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区转移率。结果：557侧颈部发生转移（41．57％），Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区转移率分别为27．61％、22．91％、9．18％、4．99％、3．24％。舌癌、口底癌Ⅲ区转移风险较高，舌癌Ⅱ区转移率明显高于Ⅰ区，口底癌、下牙龈癌、颊癌、下颌骨中枢性颌骨癌、上牙龈癌、上颌窦癌以Ⅰ区转移多见。结论：口腔颌面部鳞癌患者颈淋巴转移以Ⅰ～Ⅲ区多见，不同原发部位鳞癌Ⅰ～Ⅲ区转移的倾向性不尽相同。

Objective：To analyze the predilection of metastasis at levels Ⅰ,Ⅱ,Ⅲ, Ⅳ,Ⅴfor oral and maxillary squamous cell carcinoma on different primary sites .Methods： A retrospective review was conducted of the records of 1 233 patients （ 1 340 necks ） from January 2000 to December 2011 with squamous cell carcinoma simultaneously underwent primary tumor resection and neck dissection in De -partment of Oral and Maxillary Surgery , Peking University School and Hospital of Stomatology .The to-pography of positive neck node was recorded , and the calculation was performed for the metastasis rate of levels Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴbased on the primary site , respectively .Results：There were 557 necks with positive node （41.57%）, and the metastasis rate for level Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ were 27.61%, 22.91%, 9.18%, 4.99%, 3.24%, respectively.Those in level Ⅲ were at high risk for metastasis from carcinoma of tongue and the floor of mouth .The positive rate in level Ⅱwas more than that in levelⅠfor tongue carcinoma , but for inferior gingiva carcinoma , bucca carcinoma , upper gingiva carcinoma , palatine carcinoma , maxillary sinuse carcinoma , intraosseous carcinoma of mandibular , the positive node was more likely to happen at level Ⅰcompared with level Ⅱ.Conclusion： Most metastases happen in levels Ⅰ-Ⅲfor patients with oral and maxillary squamous cell carcinoma , but the predilection of metas-tasis in level Ⅰ,ⅡorⅢis varied with the primary sites .