口腔医学研究 ›› 2016, Vol. 32 ›› Issue (2): 154-157.DOI: 10.13701/j.cnki.kqyxyj.2016.02.012

• ·临床研究论著· • 上一篇    下一篇

口腔癌对侧颈淋巴结转移的临床研究

韩影 苏彤* 林璐 钱韵梅 熊浩峰   

  1. 中南大学湘雅医院口腔医学中心口腔颌面外科 湖南 长沙 410008
  • 收稿日期:2015-10-14 出版日期:2016-02-28 发布日期:2016-03-10
  • 通讯作者: 苏彤,E-mail:Sutongs@163.com
  • 作者简介:韩影(1990~),女,安徽人,硕士在读,主要从事口腔颌面外科学研究工作。
  • 基金资助:
    湖南省自然科学基金(编号:2015JJ4048)
    中南大学中央高校基本科研业务费专项资金(编号:2014zzts303)

Clinical Study on Cervical Lymph Nodes Metastasis of Oral Squamous Cell Carcinoma.

HAN Ying, SU Tong, LIN Lu, QIAN Yun-mei, XIONG Hao-feng   

  1. Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, Changsha 410008, China
  • Received:2015-10-14 Online:2016-02-28 Published:2016-03-10

摘要: 目的:探讨原发灶未过中线口腔癌的对侧颈淋巴结转移的相关临床病理因素,为口腔癌手术方法的选择提供依据。方法:收集2010年6月~2012年12月口腔癌238例,对年龄、性别、病程、原发灶部位、CT分期、颈清术式、病理分级、淋巴结转移等情况进行统计学分析。结果:单因素Logistic回归分析显示口腔癌对侧颈淋巴结转移在T3/T4期、中低分化、同侧淋巴结转移的患者中明显增加;多因素Logistic回归分析表明病理分级为口腔癌对侧颈淋巴结转移的高危因素。结论:在肿瘤未过中线时,如果T3/T4期、同侧颈淋巴结明确有转移、病理分级为中低分化等因素中出现两者或以上,为改善预后及提高患者治愈率,则有必要考虑同期行对侧颈清。

关键词: 口腔癌, 复发, 第二原发癌, 对侧颈淋巴结, 转移

Abstract: Objective: To evaluate the clinical pathological factors affecting contralateral neck lymph node metastasis in oral squamous cell carcinoma (OSCC), and provide clinical evidence of prophylactic contralateral neck dissection for surgeons. Methods: A total of 238 OSCC cases were retrospectively reviewed from Jun. 2010 to Dec. 2012 in the Department of Oral and Maxillofacial Surgery, Xiangya Hospital of Central South University. The impact of multiple clinicopathologic factors, including age, sex, course of disease, primary site, T-stage, type of neck dissection, ipsilateral metastatic lymph nodes and histopathological grading were assessed by logistic regression analysis. Results: Univariate logistic regression analysis showed that contralateral neck lymph node metastasis was significantly increased in the OSCC patients with T3/T4 stages, moderately and poorly cell differentiation, or ipsilateral neck lymph node metastasis. Multivariable logistic regression analysis showed that only pathology grade was high risk factor for contralateral neck lymph node metastasis of OSCC. Conclusion: Prophylactic contralateral neck dissection should be considered if patients in the middle stage of the tumor had more than two signs as followed: T3/T4 tumor stage, ipsilateral clinically lymph node-positive, and poorly differentiated.

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