华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

口腔鳞癌浸润方式与颈淋巴结转移关系的组织学研究

杨 湛1,普 苹2,温玉明3,付红梅2,李继梅4   

  1. 1.昆明医学院第一附属医院 口腔颌面外科;2.昆明医学院第一附属医院 病理科; 3.四川大学华西口腔医院 口腔颌面外科,四川 成都610041; 4.昆明医学院第一附属医院 临床研究中心,云南 昆明650032
  • 收稿日期:2005-02-25 修回日期:2005-02-25 出版日期:2005-02-20 发布日期:2005-02-20
  • 通讯作者: 杨 湛,Tel:0871-5324525
  • 作者简介:杨 湛(1964-),男,江苏人,教授,博士
  • 基金资助:
    云南省自然科学基金资助项目(96C137Q和2000C0012R)

The Histological Research between the Mode of Invasion and Cervical Lymph Node Metastasis in Squamous Cell Carcino- ma of the Oral Cavity

YANGZhan1,PUPing2,WENYu-ming3,FUHong-mei2,LIJi-mei4   

  1. 1.Dept.ofOral andMaxil- lofacial Surgery,The FirstAffiliatedHospital ofKunmingMedical College,Kunming650032,China; 2.Dept.ofPathology,The First AffiliatedHospital ofKunmingMedical College,Kunming650032,China; 3.Dept.ofOral andMaxillofacialSurgery,West China College ofStomatology,Sichuan University,Chengdu610041,China; 4.Clinical Research Center,The First Affiliated Hospital ofKunmingMedical College,Kunming650032,China
  • Received:2005-02-25 Revised:2005-02-25 Online:2005-02-20 Published:2005-02-20
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摘要:

目的 探讨口腔鳞癌不同浸润方式和颈淋巴结转移的关系。方法 利用Yamamoto的浸润方式分型法,对 200例临床和病理资料完整的口腔鳞癌患者进行组织学回顾性研究和分析。结果 鳞癌的浸润方式与鳞癌的颈淋巴结转移明显相关(P<0·001)。Ⅰ型~Ⅳd型浸润方式相对应的颈淋巴结转移率分别为0、5·9%、14·3%、63·0% 和82·9%。在80例Ⅲ~Ⅳd型浸润方式的转移患者中,Ⅳd型浸润方式常伴随N2期转移(P<0·05),而Ⅲ型和Ⅳc 型浸润方式则更常伴有N1期转移(P<0·05)。Ⅳc型浸润有41·2%的Ⅰ级平面和79·4%的Ⅰ~Ⅱ级平面转移机率,而Ⅳd型浸润的转移平面较为弥散,两者间有显著性差异(P<0·05)。结论 不同的口腔鳞癌浸润方式有着截然不同的颈淋巴结转移机率、转移分期和转移平面。对口腔鳞癌原发灶肿瘤-宿主边缘浸润方式的分型研究,有助于判断口腔鳞癌的区域性淋巴结转移情况,提供临床治疗方案设计和预后预测的依据。

关键词: 口腔鳞癌, 淋巴结转移, 浸润方式

Abstract:

Objective The relationship between the mode of tumor invasion in the tumor-host borderline and the frequency of cervical lymph node metastasiswas investigated in squamous cell carcinoma of the oral cavity.Methods 200 caseswith histologi- cally proven squamous cell carcinoma of the oral cavitywere studied by histological methodwithHE stained. The mode of invasion in the tumor-host relationship was classified into five grades by Yamamoto′s criteria.Results With regard to the relationship be- tween the mode of invasion and metastasis, the more invasive the tumor tissue was, the more frequent the metastasis formed (P< 0·001). The frequency of metastasis in grades 1 and 2 was low (0 and 5·9%, respectively),The frequency of metastasis in grades 3 was moderate (14·3%), and that in grades 4c and 4d was highly rapid (63·0% and 82·9%, respectively). Single node metastases were frequent in grade 3 and grade 4c (66·7% and 58·8%, respectively), while plural node metastases were frequent in grade 4d (70·6%,P<0·05 ). Moreover, the distribution of metastasized lymph nodes was focused on level 1 (41·2%)or level 1 and 2 (79·4%) in grade 4c and was dispersed from level 1 to 4 in grade 4d (P<0·05). In the present study, the degree of differentiation did not correlate wellwith the frequency of metastasis.Conclusion These results indicate that the more invasive the tumor cells were to the host, the more frequent the metastasis formed. The different mode of invasion would accompany with different frequency of metastasis, different number and distribution of metastasized lymph nodes.

Key words: oral squamous cell carcinoma, lymph node metastases, the mode of invasion