口腔鳞状细胞癌切缘状态评估及其影响因素分析

Evaluation and influencing factors of surgical margin status of oral squamous cell carcinoma

合适的外科切缘是根治口腔鳞状细胞癌的重要手段之一。目前，安全切缘为光镜下≥5mm。对临床医师而言，术前和术中准确判断切除范围，达到足够的安全切缘距离，是减少局部复发的关键。本文就口腔鳞状细胞癌的外科切缘状态与患者预后的相关性、影响切缘状态的若干因素进行综述。笔者认为，口腔鳞状细胞癌安全切缘的判断应综合局部解剖特点、肿瘤浸润深度和方式、切缘上皮组织异常增殖程度等因素。

Surgical resection with adequate margins is an essential component of the treatment for patients with oral squamous cell carcinoma （OSCC）. A distance of 5 mm or more between healthy tissue to the tumor front is generally accepted as a safe margin. It is very important for surgeons to precisely evaluate the resection area of tumor both pre- and intra-operatively and try to achieve a safe margin, which will result in a decreased risk of local recurrence. The relationship of surgical margin status to patients＇ prognosis, and factors which will affect surgical margin distance demand are discussed in this paper. We recommend that adequate margins evaluation should take consideration of many factors such as anatomical location, depth of tumor invasion, pattern of tumor invasion, mucosal dysplasia grade and so on. With the development of molecular biology, surgical margin study at molecular level can give us a new strategy to evaluate its adequacy.