635例口腔鳞状细胞癌临床病理特征及发病特点分析

Analysis on the Clinicopathological Features and Pathogenesis of 635 Cases of Oral Squamous Cell Carcinoma

目的分析河南地区口腔鳞状细胞癌(OSCC)临床病理特征,探讨本地区OSCC的发病特点。方法收集郑州大学第一附属医院手术切除的OSCC患者635例,观察分析其临床病理特征,比较发生在口腔不同部位OSCC的差异。分析本地区OSCC的发病特点。结果 635例OSCC患者中,以上下颌牙龈癌(37. 32%)及舌部癌(36. 22%)为多见,其余依次为颊部癌(14. 96%)、口底癌(6. 61%)及腭部癌(4. 88%);男性患者多于女性(60. 79%vs 39. 21%),但颊部癌女性更常见(47. 37%vs 52. 63%);≥60岁患者多于<60岁患者(56. 38%vs 43. 62%),但舌部癌(60. 00%)及口底癌(59. 52%)则是以<60岁为多见;本组OSCC病例中以中、高分化为多见(分别为51. 81%、41. 26%),且淋巴结转移率仅为18. 27%。此外T1期、T2期(53. 70%、38. 58%)多见,T3期仅为7. 72%。TNM分期以Ⅰ期、Ⅱ期(46. 45%、28. 98%)更多见。结论河南地区OSCC好发部位为上下颌牙龈及舌部,男性患癌多于女性,≥60岁更常见,组织学分化以中、高分化为主,且早期病例多于晚期病例。颊部癌以女性多见,舌部癌及口底癌更趋向年轻化。

Objective To analyze the clinicopathologic features and the clinical characteristics of oral squamous cell carcinoma( OSCC) in Henan province. Methods 635 cases of OSCC from the First Affiliated Hospital of Zhengzhou University was collected. The clinicopathological features of these cases were observed and analyzed.The differences of OSCC in different parts of oral cavity were compared. The clinical characteristics of OSCC in this area were analyzed. Results Among the 635 patients with OSCC,the carcinoma of maxillary and mandibular gingival( 37. 32%) and carcinoma of tongue( 36. 22%) were common,followed by carcinoma of buccal mucosa( 14. 96%),carcinoma of the floor of mouth( 6. 61%) and carcinoma of palate( 4. 88%). There were more patients in males than in females( 60. 79% vs 39. 21%),excepted for carcinoma of buccal( males: 47. 37%,females: 39. 21%). There were more patients over 60 years old( 60. 79%) than under 60 years old( 43. 62%),but in carcinoma of tongue and carcinoma of the floor of mouth,the result was the opposite,patients under 60 years old were more common( carcinoma of tongue: 60. 00%,carcinoma of the floor of mouth: 59. 52%). In this group,the OSCC cases were mostly high-middle differentiated( 51. 81% and 41. 26% respectively),and the lymph node metastasis rate was only 18. 27%. In addition,T1( 53. 70%) and T2( 38. 58%) were more common,while T3 was only 7. 72%. TNM stage Ⅰ( 46. 45%),stage Ⅱ( 28. 98%) were more common. Conclusion In Henan province,OSCC mainly occurred in the maxillary and mandibular gingival and tongue. OSCC affects males more tha females,and it is more common over 60 years old. The histological differentiation is mainly medium-to-high,and the early patients are more than the late patients. Carcinoma of buccal is more common in females,and carcinoma of tongue and the floor of mouth tend to be younger.