cT1N0M0期舌鳞状细胞癌颈淋巴结处理的临床观察与研究

A Clinical Observation and Study on the Management of Neck Lymph Nodes in Patients with Stage CT1N0M0 Tongue Squamous Cell Carcinoma

目的:观察与研究选择性颈部淋巴结清扫术对于cT1N0M0期舌鳞状细胞癌的疗效及其与肿瘤浸润深度、分化程度,患者生存情况、生存率的关系。方法:回顾36例cT1N0M0期舌鳞状细胞癌患者的资料,将患者分为选择性颈部淋巴结清扫组(选择性颈清组,23例)和观察组(13例)。对患者的临床病历、随访资料、病理结果等进行分析。结果:36例病例5年生存率达97.2%,其中1例于术后52个月时死亡;23例选择性颈清组隐匿性颈部淋巴结转移率为0%;观察组病理分级为Ⅲ级、浸润深度为4~5 mm的患者,5年生存率为50%。结论:选择性颈部淋巴结清扫术和颈部随访观察2种颈部处理方法对cT1N0M0期舌鳞状细胞癌患者的生存状态、生存率影响无明显差异(P>0.05),肿瘤的分化程度、浸润深度是实施选择性颈淋巴结清扫术的重要参考依据和影响生存率的危险因素。

Objective:To observe and study the efficacy of selective neck dissection in the treatment for stage cT1N0M0 tongue squamous cell carcinoma and its relationship with depth of invasion,and degree of differentiation of tumors,patients′survival state and survival rate.Methods:The data of 36 patients with cT1N0M0 stage tongue squamous cell carcinoma were reviewed.And the patients were divided into two groups:the selective neck dissection group(n=23)and the observation group(n=13).The clinical records,follow-up data and pathological results of the patients were analyzed.Results:One of the 36 patients died at 52 months after operation,and the 5-year survival rate of patients reached 97.2%.In the selective neck dissection group,the occult neck lymph node metastasis rate was 0%.In the observation group,the 5-year survival rate was 50%in patient with tumor′s pathological grade ofⅢand invasion depth of 4-5 mm.Conclusion:There was no significant difference in survival state and survival rate of patients with stage cT1N0M0 tongue squamous cell carcinoma between the selective neck dissection group and the observation group(P>0.05).The degree of differentiation and depth of invasion of tumor were important references for the selection of selective neck dissection and risk factors affecting survival rate.