口腔癌浸润深度的研究进展

Research progress on the depth of invasion of oral carcinoma

2020年全球口腔癌新发病例377,713(2.0%),死亡病例177,757(1.8%),位居36种癌症中第18位,是严重危害人类生命健康的恶性疾病之一。在2017年美国癌症联合委员会所发布的第8版TNM分期手册(AJCC8)中,肿瘤大小不再是判断口腔癌T分期的唯一标准,新的分期系统中加入了浸润深度(depth of invasion,DOI)等新的指标,在诸多研究中肿瘤浸润深度被认为是预测口腔癌淋巴结转移的良好预测因子,也是预测隐匿性淋巴结转移和患者临床预后的指标之一,受到了人们的广泛关注。笔者通过查阅有关口腔癌浸润深度的国内外文献,熟悉掌握了浸润深度定义,测量方法以及临床应用。本文分别从浸润深度测量方法、浸润深度与淋巴结转移关系、浸润深度对口腔癌预后影响等三个方面阐述诸多学者的研究结果。文献复习结果表明,浸润深度的加入使患者原有TNM分期发生了改变,提高了不同TNM分期的预测价值和分层,能够识别生存率降低的高风险患者,对于口腔癌患者治疗方案以及预后评估有着深远意义。

In 2020,there were 377,713 new cases of oral cancer(2.0%)and 177,757 deaths(1.8%)in the world,ranking 18th among 36 types of cancer.It is one of the malignant diseases that seriously endanger human life and health.In the 8th edition of the TNM staging manual(AJCC8)released by the Joint Committee on Cancer in 2017,tumor size is no longer the only criterion for judging the T stage of oral cancer,and new indexes such as depth of invasion(DOI)are added to the new staging system.In many studies,the depth of tumor invasion is considered to be a good predictor of oral cancer lymph node metastasis,as well as one of the indicators that predict occult lymph node metastasis and clinical prognosis of patients.It has received a lot of attention.The author has been familiar with the definition,measurement method and clinical application of infiltration depth of oral cancer by referring to the literature at home and abroad.In this paper,the study results of many scholars are described from three aspects:the measurement method of depth of invasion,the relationship between depth of invasion and lymph node metastasis,and the impact of depth of invasion on the prognosis of oral cancer.The results of literature review show that the addition of invasion depth changes the original TNM stage of patients,improves the predictive value and stratification of different TNM stages,and can identify high-risk patients with reduced survival rate,which has far-reaching significance for the treatment plan and prognosis evaluation of oral cancer patients.