北京大学学报（医学版）
北京大學學報（醫學版）
북경대학학보（의학판）
JOURNAL OF BEIJING MEDICAL UNIVERSITY(HEALTH SCIENCES)
2014年
3期
469-473
,共5页
癌%鳞状细胞%淋巴转移%上颌肿瘤%外科,口腔%颈
癌%鱗狀細胞%淋巴轉移%上頜腫瘤%外科,口腔%頸
암%린상세포%림파전이%상합종류%외과,구강%경
Carcinoma%squamous cell%Lymphatic metastasis%Maxillary neoplasms%Surgery,oral%Neck
目的：分析口腔颌面部不同原发部位鳞癌颈部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区转移倾向性。方法：回顾性收集北京大学口腔医院口腔颌面外科2000年1月至2011年12月1233例（1340侧）同期行颈淋巴清扫术及原发灶切除的口腔颌面部鳞状细胞癌患者资料，记录颈部淋巴结转移部位，分别计算不同原发部位鳞癌颈部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区转移率。结果：557侧颈部发生转移（41．57％），Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区转移率分别为27．61％、22．91％、9．18％、4．99％、3．24％。舌癌、口底癌Ⅲ区转移风险较高，舌癌Ⅱ区转移率明显高于Ⅰ区，口底癌、下牙龈癌、颊癌、下颌骨中枢性颌骨癌、上牙龈癌、上颌窦癌以Ⅰ区转移多见。结论：口腔颌面部鳞癌患者颈淋巴转移以Ⅰ～Ⅲ区多见，不同原发部位鳞癌Ⅰ～Ⅲ区转移的倾向性不尽相同。
目的：分析口腔頜麵部不同原髮部位鱗癌頸部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ區轉移傾嚮性。方法：迴顧性收集北京大學口腔醫院口腔頜麵外科2000年1月至2011年12月1233例（1340側）同期行頸淋巴清掃術及原髮竈切除的口腔頜麵部鱗狀細胞癌患者資料，記錄頸部淋巴結轉移部位，分彆計算不同原髮部位鱗癌頸部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ區轉移率。結果：557側頸部髮生轉移（41．57％），Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ區轉移率分彆為27．61％、22．91％、9．18％、4．99％、3．24％。舌癌、口底癌Ⅲ區轉移風險較高，舌癌Ⅱ區轉移率明顯高于Ⅰ區，口底癌、下牙齦癌、頰癌、下頜骨中樞性頜骨癌、上牙齦癌、上頜竇癌以Ⅰ區轉移多見。結論：口腔頜麵部鱗癌患者頸淋巴轉移以Ⅰ～Ⅲ區多見，不同原髮部位鱗癌Ⅰ～Ⅲ區轉移的傾嚮性不儘相同。
목적：분석구강합면부불동원발부위린암경부Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ구전이경향성。방법：회고성수집북경대학구강의원구강합면외과2000년1월지2011년12월1233례（1340측）동기행경림파청소술급원발조절제적구강합면부린상세포암환자자료，기록경부림파결전이부위，분별계산불동원발부위린암경부Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ구전이솔。결과：557측경부발생전이（41．57％），Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ구전이솔분별위27．61％、22．91％、9．18％、4．99％、3．24％。설암、구저암Ⅲ구전이풍험교고，설암Ⅱ구전이솔명현고우Ⅰ구，구저암、하아간암、협암、하합골중추성합골암、상아간암、상합두암이Ⅰ구전이다견。결론：구강합면부린암환자경림파전이이Ⅰ～Ⅲ구다견，불동원발부위린암Ⅰ～Ⅲ구전이적경향성불진상동。
Objective:To analyze the predilection of metastasis at levels Ⅰ,Ⅱ,Ⅲ, Ⅳ,Ⅴfor oral and maxillary squamous cell carcinoma on different primary sites .Methods: A retrospective review was conducted of the records of 1 233 patients ( 1 340 necks ) from January 2000 to December 2011 with squamous cell carcinoma simultaneously underwent primary tumor resection and neck dissection in De -partment of Oral and Maxillary Surgery , Peking University School and Hospital of Stomatology .The to-pography of positive neck node was recorded , and the calculation was performed for the metastasis rate of levels Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴbased on the primary site , respectively .Results:There were 557 necks with positive node (41.57%), and the metastasis rate for level Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ were 27.61%, 22.91%, 9.18%, 4.99%, 3.24%, respectively.Those in level Ⅲ were at high risk for metastasis from carcinoma of tongue and the floor of mouth .The positive rate in level Ⅱwas more than that in levelⅠfor tongue carcinoma , but for inferior gingiva carcinoma , bucca carcinoma , upper gingiva carcinoma , palatine carcinoma , maxillary sinuse carcinoma , intraosseous carcinoma of mandibular , the positive node was more likely to happen at level Ⅰcompared with level Ⅱ.Conclusion: Most metastases happen in levels Ⅰ-Ⅲfor patients with oral and maxillary squamous cell carcinoma , but the predilection of metas-tasis in level Ⅰ,ⅡorⅢis varied with the primary sites .
