上颌鳞状细胞癌颈部淋巴结转移及生存分析

Analysis of cervical lymph node metastasis and survival of the patients with maxillary squamous cell carcinoma

目的:研究临床颈部淋巴结阴性的上颌鳞癌(c N0 MSCC)患者的隐匿性淋巴结转移率,评价选择性颈淋巴清除术的意义。方法:回顾手术治疗的MSCC患者的病例资料58例,统计学方法分析MSCC患者的颈部淋巴结转移率、区域复发率、生存率及相关因素。结果:隐匿性颈部淋巴结转移率28.8%,颈部淋巴结转移率39.7%,5年生存率59.0%;p T4期、肿瘤侵犯软腭为MSCC患者颈部淋巴结转移率的独立危险因素;肿瘤低分化、浸润神经血管是生存的独立危险因素。结论:对p T4期尤其伴骨组织或软腭侵犯的c N0 MSCC患者建议行Ⅰ~Ⅲ区的选择性颈部淋巴结清扫。

Objective: To study the rate of occult lymph node metastasis in patients of maxillary squamous cell carcinoma with negative cervical lymph nodes(cN0 MSCC) and to evaluate the condition for elective neck dissection. Methods: The data of 58 cases of MSCC treated by surgery were included, the cervical lymph node metastasis rate, regional recurrence rate, survival rate and related factors were analyzed by statistical method. Results: The rate of occult cervical lymph node metastasis was 28.8%. The rate of cervical lymph node metastasis was 39.7%. The 5-year survival rate was 59.0%.PT4 and tumor invasion of the soft palate were the independent risk factors for cervical lymph node metastasis in patients with MSCC. Poorly differentiated tumors and neurovascular infiltration were the independent risk factors for survival. Conclusion: Elective cervical lymph node dissection is recommended for cN0 MSCC patients in pT4 stage, especially in patients with bone tissue or soft palate invasion.