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301例口腔癌颈部淋巴结处理的随访研究

  来源:120online      日期:2007-05-07
中华口腔医学杂志2000年第2期第35卷论著作者:周宏志 顾晓明单位:第四军医大学口腔医学院口腔颌面外科,西安,710032关键词:癌;鳞状细胞;口腔肿瘤;肿瘤转移;外科手术...

  【摘要】 目的 评价口腔癌的发生部位和TNM分期对颈淋巴结转移及外科处理的影响。方法 随访301例首诊治疗口腔癌患者,计算颈淋巴结转移病理检出率、单纯原发灶切除后颈淋巴结复发率、颈淋巴清扫后颈淋巴结复发率。结果 病理转移检出率41.6%,舌、口底、下龈、颊癌单纯原发灶切除后淋巴结复发率32.1%,功能性颈淋巴清扫术后复发率14.7%。结论 TNM分期是临床判断淋巴结转移的有效依据,对发生于上述4个部位的鳞癌应扩大选择性颈淋巴清扫的适应证,选择功能性颈淋巴清扫术需慎重。

Surgical treatment of cervical lymph nodes in 301 patients with oral squamous cell carcinoma

ZHOU Hongzhi, GU Xiaoming.

  (Department of Oral Maxillofacial Surgery, College of Stomatology,The Fourth Military Medical University, Xi'an 710032, China)

  【Abstract】 Objective To evaluate cervical lymph metastases and its surgical treatment of oral carcinoma with regard to primary location and TNM classification.Methods 301 previously untreated patients were included in the follow-up study to calculate the rate of histopathologically positive lymph metastasis and the rate of recurrences in untreated necks and after FND (functional neck dissection).Results Lymph node pathologic positive rates were N0 7.4%, N1 14.7%, N2 76.2%. Recurrences occurred in 32.1% untreated necks and 14.7% necks after FND of carcinomas of tongue, bucca, lower-gingiva and oral floor, while rarely in necks of carcinomas of palate and upper-gingiva.Conclusions TNM classification is useful to estimate lymph metastasis. Application of elective neck dissection needs to expand in carcinomas of the above four sites. It should be careful when choose FND.

  【Key words】 Carcinoma, squamous cell; Mouth neoplasms; Neoplasm metastasis; Surgery, operative

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