本文選題：舌癌 + 頸淋巴結(jié)轉(zhuǎn)移��； 參考：《腫瘤防治研究》2014年07期

【摘要】：目的探討舌癌隱匿性頸淋巴結(jié)轉(zhuǎn)移規(guī)律和相關(guān)影響因素,以及不同頸淋巴清掃術(shù)式對(duì)舌癌的預(yù)后影響,為cN0期舌癌患者頸淋巴清掃術(shù)術(shù)式的選擇提供理論依據(jù)。方法收集2002年1月至2010年8月在廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院頭頸外科初治的cN0期舌癌住院患者87例。通過單因素分析隱匿性頸淋巴結(jié)轉(zhuǎn)移與年齡、性別、術(shù)前疾病持續(xù)時(shí)間、原發(fā)灶浸潤深度、T分期、病理分級(jí)的相關(guān)性,多因素分析cN0期舌癌患者的預(yù)后影響因素,探討舌鱗癌頸部轉(zhuǎn)移規(guī)律及外科處理方式。結(jié)果單因素統(tǒng)計(jì)分析顯示:性別、年齡、術(shù)前疾病持續(xù)時(shí)間對(duì)cN0期舌癌患者隱匿性頸淋巴結(jié)轉(zhuǎn)移的影響差異無統(tǒng)計(jì)學(xué)意義(P0.05),而原發(fā)灶浸潤深度、T分期、病理分級(jí)等因素對(duì)頸淋巴結(jié)轉(zhuǎn)移的影響差異有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Cox風(fēng)險(xiǎn)比例模型分析顯示:只有T分期是舌癌cN0期患者的獨(dú)立預(yù)后因素,不同頸淋巴清掃術(shù)對(duì)其預(yù)后的影響差異無統(tǒng)計(jì)學(xué)意義。頸擇區(qū)性淋巴清掃術(shù)對(duì)肩部的影響更小(P0.05)。結(jié)論原發(fā)灶浸潤深度、T分期、病理分級(jí)與cN0期舌癌隱匿性頸淋巴結(jié)轉(zhuǎn)移有關(guān),可以作為預(yù)測(cè)cN0期舌癌隱匿性頸淋巴結(jié)轉(zhuǎn)移的指標(biāo);cN0期舌癌具有較高的隱匿性頸部淋巴結(jié)轉(zhuǎn)移率,以同側(cè)頸部Ⅰ、Ⅱ、Ⅲ區(qū)最為常見,主張行頸擇區(qū)淋巴清掃術(shù)。
[Abstract]:Objective to investigate the law of occult cervical lymph node metastasis in tongue cancer and the influence of different neck dissection on the prognosis of tongue cancer, and to provide a theoretical basis for the choice of cervical lymph node dissection in patients with cN0's carcinoma of tongue.Methods from January 2002 to August 2010, 87 patients with cN0 stage tongue cancer were treated in head and neck surgery, affiliated Cancer Hospital of Guangxi Medical University.By univariate analysis of the correlation between occult cervical lymph node metastasis and age, sex, duration of disease before operation, depth of invasion of primary tumor and T stage, pathological grade, multivariate analysis of prognostic factors in cN0 patients with tongue cancer.To investigate the law of cervical metastasis and surgical management of tongue squamous cell carcinoma.Results the univariate statistical analysis showed that there was no significant difference in the influence of sex, age and preoperative disease duration on the occult cervical lymph node metastasis in patients with cN0 stage tongue cancer.The influence of pathological grade on cervical lymph node metastasis was significantly different (P 0.05).Multivariate Cox risk ratio model analysis showed that only T stage was an independent prognostic factor in patients with cN0 stage of tongue cancer. There was no significant difference in the influence of different neck dissection on the prognosis of patients with tongue cancer.The effect of cervical lymph node dissection on shoulder was smaller than that of P0.05.Conclusion T stage and pathological grade of primary tumor invasion are related to occult cervical lymph node metastasis of tongue carcinoma in cN0 stage, which can be used as a predictor of occult cervical lymph node metastasis in cN0 stage tongue cancer.The ipsilateral neck regions 鈪，

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