口腔鳞癌患者颈淋巴结cN_0的处理

Treatment to cN_0 Patients with Oral Squamous Cell Carcinoma

目的 探讨口腔鳞癌颈淋巴结转移的发生规律及对cN0 患者的治疗原则。方法 通过对四川大学华西口腔医院颌面外科 1980～ 2 0 0 1年住院的 10 2 4例口腔鳞癌患者的临床资料进行回顾性分析。结果 口腔鳞癌患者颈淋巴结的总体转移率为 36 6 2 %,其中舌癌转移率最高为 42 82 %,颊癌和下牙龈癌相近分别为 31 93%和32 76 %,口底癌转移率最低为 2 5 .0 0 %;cN0 患者的颈淋巴结隐匿性转移率为 2 0 94%。口腔鳞癌的隐匿性转移与原发灶的部位、T分期等密切相关。结论 临床上应根据患者肿瘤原发灶的部位、大小和临床分期等综合考虑分析 ,判断颈淋巴结情况 ,从而选择合理的治疗方案。

Objective To investigate the regularity of cervical lymph-node metastasis in oral squamous cell carcinoma patients and determine the treatment principle to cN-0 patients.Methods 1 024 oral squamous cell carcinoma cases who underwent neck dissection between 1980～2001 were investigated retrospectively. Results The total rate of cervical lymph-node metastasis of oral squamous cell carcinoma was 36.62%(375/1 024), the metastasis rate of cancer in tongue, buccal, gingival, and floor of mouth was 42.82%, 31.93%, 32.76%, and 25.00%, respectively; the rate of occult metastasis was 20.94%(71/339), the incidence of occult metastasis was closely related to the location of primary lesion and T stage.Conclusion The results in this study revealed that the therapy regime of the oral squamous cell carcinoma should be based on carefully clinical examination and compositive analysis on primary lesion related to size, location and cervical lymph-node.