华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

颊黏膜鳞癌cN_0患者的颈部处理

吴正华,黄欣,康非吾,温玉明,王昌美   

  1. 610041 四川大学华西口腔医院口腔颌面外科
  • 收稿日期:2003-06-25 修回日期:2003-06-25 出版日期:2003-06-20 发布日期:2003-06-20

The Neck Treatment of cN0 Patients with Squamous Cell Carcinoma of Buccal Mucosa

WU Zhenghua, HUANG Xin, KANG Feiwu, et al.   

  1. Department of Oral and Maxillofacial Surgery, West China College of Stomatology,Sichuan University, Chengdu 610041,China
  • Received:2003-06-25 Revised:2003-06-25 Online:2003-06-20 Published:2003-06-20

摘要:

目的 探讨颊黏膜鳞癌cN0 患者的颈部处理原则。方法 对四川大学华西口腔医院颌面外科1 980~ 2 0 0 0年收治的 1 0 1例颊黏膜鳞癌cN0 患者进行回顾性研究。所有患者均行原发灶切除加同期或二期颈清扫术 ,有的患者还兼行化疗、放疗。术后淋巴结作病理学检查 ,随访 3年以上。结果  101例颊黏膜鳞癌cN0 患者中有17例发生颈淋巴结转移 ,淋巴结隐匿性转移 (OM)率为16.83% ,且随临床T分期的增高而增高 ,T3和T4期的隐匿性转移率分别为18.18%和 52.00% ;转移淋巴结主要分布于颌下淋巴结组 (41.18% )和颈深上淋巴结组(29.41%)。结论 颊黏膜鳞癌颈部隐匿性转移率较高 ,对T3,4 期的cN0 颊黏膜鳞癌患者应考虑行选择性同期全颈清扫术。

关键词: 颊黏膜鳞癌, 淋巴结, 隐匿性转移, 颈清扫术

Abstract:

Objective The purpose of this study was to discuss the principle in neck treatment of cN\-0 patients with squamous cell carcinoma of buccal mucosa.Methods 101 patients of squamous cell carcinoma of buccal mucosa at the stage of cN\-0, who had hospitalized in West China College of Stomatology, Sichuan University from 1980 to 2000, were investigated retrospectively. All the patients received a comprehensive therapy consisting of surgical procedures combined with chemotherapy and radiotherapy. The combining radical therapy of buccal, mandible and neck was the main surgical method. Lymph nodes were cleared after operation and examined by pathological method. The patients had been followed up for more than 3 years.Results 17 patients had lymph nodes metastasis, the occult metastasis (OM) rate was 16.83%. It increased in the high stage of original lesion, the OM rate of T\-3 and T\-4 was 18 18% and 52.00%, respectively. The metastasized lymph nodes were mainly located in submandible and superior deep cervix lymph nodes, their respective metastasis rate was 41 18% and 29 41%.Conclusion The rate of occult metastasis of squamous cell carcinoma of buccal mucosa is high, and then we should adopt actively selective neck dissection for the cN\-0 patients of squamous cell carcinoma of buccal mucosa.

Key words: squamous cell carcinoma of buccal mucosa, lymph node, occult metastasis, neck dissection