口腔颌面癌瘤的颈淋巴结转移及颈淋巴清扫术的临床研究

Retrospective study of cervical lymph node metastases from oral and maxillofacial carcinoma

目的 探讨口腔颌面癌瘤颈淋巴结转移的部分规律及其与颈淋巴清扫术间的关系。方法 对 2 5 0例行颈淋巴清扫联合根治术的口腔颌面癌病例进行回顾性研究。结果 口腔颌面癌颈淋巴结转移率为 18.8% ,其中鳞癌的颈淋巴结转移率为 2 3.4% ,腺上皮源性癌颈淋巴结转移率为 9.6 % ;颈淋巴结转移临床诊断与病理诊断符合率为 5 8.4% ,漏诊率为 9.1%。结论 鳞状上皮细胞癌比腺上皮源性癌更易发生颈淋巴结转移 ;临床诊断阳性的颈淋巴结应实施颈淋巴清扫术 ,对N0 期颈淋巴结应采取适时动态监测 。

Objective To assess the metastatic pattern and its relationship with radical neck dissection of oral and maxillofacial carcinoma .Methods 250 cases with oral and maxillofacial cacinoma having been made radical neck dissection were retrodpectively analyzed .Results The cervical lymph node metastatic rate of oral and maxillofacial carcinoma was 18.8%?The cervical lymph node metastatic rate of squamous cell carcinoma was 23.4%,while the cervical lymph node metastatic rate of adenoid epithelial cell carcinoma was 9.6%.The correspondence rate between clinic and pathology diagnosis on cervical lymph node metastatases was 58.4%,otherwise the missing diagnosis rate was 9.1%.Conclusion The squamous cell carcinoma has higher cervical lymph node metastatic rate than adenoid epithelial cell carcinoma(P< 0.05).When the clinic diagnosis suspected cervical lymph node metastatases ,the radical neck dissection should be made .But ,a dynamic monitoring on no cervical lymph node metastatases signs should be adopt ,meanwhile during this period the radical neck dissection was unnecessary.