实用口腔医学杂志
實用口腔醫學雜誌
실용구강의학잡지
JOURNAL OF PRACTICAL STOMATOLOGY
2014年
5期
676-679
,共4页
口腔癌%淋巴结转移%包膜外侵犯%侵犯方向%分化程度%肿瘤浸润厚度%淋巴结
口腔癌%淋巴結轉移%包膜外侵犯%侵犯方嚮%分化程度%腫瘤浸潤厚度%淋巴結
구강암%림파결전이%포막외침범%침범방향%분화정도%종류침윤후도%림파결
Oral squamous cell carcinoma%Lymph node metastasis%Extracapsular spread(ECS)%Spread di-rection%Differentiation degree%Tumor thickness%Lymph node size
目的：探讨口腔鳞状细胞癌在颈部淋巴结的包膜外侵犯（ECS）在各淋巴结分区的浸润方向的差异性。方法：纳入术后病理证实颈部淋巴结转移阳性患者57例。对淋巴结ECS方向的差异性及ECS与病灶T分级、浸润厚度、分化程度，淋巴结大小等之间的关系进行相关分析。结果：57例患者中，30例发生ECS，发生ECS的淋巴结共78个（转移阳性淋巴结共174个），ECS在淋巴结浅面的发生频次为66，深面为51。其中Ⅰ区发生ECS者29个淋巴结，浅面ECS频次为26，深面为13（P＜0．05）。其他各区ECS的浸润方向差异无显著性。ECS发生率与原发灶T分期无明显相关性（P＞0．05）；与原发灶浸润厚度（P＜0．05）、肿瘤分化程度（P＜0．05）及淋巴结直径（P＜0．01）相关。结论：口腔鳞癌颈部Ⅰ区淋巴结浅面发生ECS的概率较深面大。颈淋巴结ECS的发生率与口腔癌肿瘤浸润厚度、淋巴结直径正相关，与肿瘤分化程度负相关。
目的：探討口腔鱗狀細胞癌在頸部淋巴結的包膜外侵犯（ECS）在各淋巴結分區的浸潤方嚮的差異性。方法：納入術後病理證實頸部淋巴結轉移暘性患者57例。對淋巴結ECS方嚮的差異性及ECS與病竈T分級、浸潤厚度、分化程度，淋巴結大小等之間的關繫進行相關分析。結果：57例患者中，30例髮生ECS，髮生ECS的淋巴結共78箇（轉移暘性淋巴結共174箇），ECS在淋巴結淺麵的髮生頻次為66，深麵為51。其中Ⅰ區髮生ECS者29箇淋巴結，淺麵ECS頻次為26，深麵為13（P＜0．05）。其他各區ECS的浸潤方嚮差異無顯著性。ECS髮生率與原髮竈T分期無明顯相關性（P＞0．05）；與原髮竈浸潤厚度（P＜0．05）、腫瘤分化程度（P＜0．05）及淋巴結直徑（P＜0．01）相關。結論：口腔鱗癌頸部Ⅰ區淋巴結淺麵髮生ECS的概率較深麵大。頸淋巴結ECS的髮生率與口腔癌腫瘤浸潤厚度、淋巴結直徑正相關，與腫瘤分化程度負相關。
목적：탐토구강린상세포암재경부림파결적포막외침범（ECS）재각림파결분구적침윤방향적차이성。방법：납입술후병리증실경부림파결전이양성환자57례。대림파결ECS방향적차이성급ECS여병조T분급、침윤후도、분화정도，림파결대소등지간적관계진행상관분석。결과：57례환자중，30례발생ECS，발생ECS적림파결공78개（전이양성림파결공174개），ECS재림파결천면적발생빈차위66，심면위51。기중Ⅰ구발생ECS자29개림파결，천면ECS빈차위26，심면위13（P＜0．05）。기타각구ECS적침윤방향차이무현저성。ECS발생솔여원발조T분기무명현상관성（P＞0．05）；여원발조침윤후도（P＜0．05）、종류분화정도（P＜0．05）급림파결직경（P＜0．01）상관。결론：구강린암경부Ⅰ구림파결천면발생ECS적개솔교심면대。경림파결ECS적발생솔여구강암종류침윤후도、림파결직경정상관，여종류분화정도부상관。
Objective:To study the direction of cervical node extracapsular spread(ECS)of oral squamous cell carcinoma(OSCC). Methods:57 cases of OSCC were treated by combined radical operation.The relationship between ECS and T stage,tumor thick-ness,differentiation degree of OSCC,lymph node size and the ECS direction in each lymph node level were statistically analysed. Results:ECS was found in 30 of the 57 cases,and in 78 of the 174 metastasis positive lymph nodes.29 ECS nodes in levelⅠ,the frequency of the shallow side was 26,the deep side 13(P=0.000 3).But the difference in other levels was not statistically signifi-cant(P>0.05).It was not statistically significant between the incidence of ECS and T stage;it was statistically significant between the incidence of ECS and tumor thickness(P<0.05),tumor differentiation degree(P<0.05)and the lymph node size(P<0.01). Conclusion:ECS of OSCC on the shallow side is more than that in the deep side of lymph nodes in levelⅠ.ECS is positively corre-lated with the tumor thickness of OSCC,metastasied lymph node size;negatively related to the differentiation degree of OSCC.
