本文選題：淋巴結(jié) + 上頜骨腫瘤�。� 參考：《北京大學(xué)學(xué)報(醫(yī)學(xué)版)》2017年06期

【摘要】：目的:探討和比較不同病理類型臨床頸淋巴結(jié)陰性(clinically negative neck lymph node,c N0)上頜惡性腫瘤的頸淋巴結(jié)轉(zhuǎn)移率,為此類患者頸部淋巴結(jié)的處理提供參考。方法:選擇1990年至2010年就診于北京大學(xué)口腔醫(yī)院具有完整臨床及隨訪資料的c N0上頜惡性腫瘤患者277例,記錄頸淋巴結(jié)轉(zhuǎn)移情況及相關(guān)臨床信息,研究不同病理類型上頜惡性腫瘤頸淋巴結(jié)轉(zhuǎn)移的發(fā)生規(guī)律,并通過SPSS 19.0統(tǒng)計學(xué)軟件分析影響上頸惡性腫瘤淋巴結(jié)轉(zhuǎn)移的相關(guān)因素。結(jié)果:277例c N0上頜惡性腫瘤患者的總體頸淋巴結(jié)轉(zhuǎn)移發(fā)生率為15.5%(43/277),上頜鱗狀細胞癌因其較強的淋巴結(jié)轉(zhuǎn)移傾向,頸淋巴結(jié)轉(zhuǎn)移率為33.0%;腺源性癌的整體轉(zhuǎn)移率較低,為7.6%,且發(fā)生頸淋巴結(jié)轉(zhuǎn)移的時間較晚,但高度惡性腺源性癌的淋巴結(jié)轉(zhuǎn)移率明顯高于中、低度惡性腺源性癌(分別為P=0.037),其中非特異性腺癌、低分化黏液表皮樣癌、導(dǎo)管癌的頸淋巴結(jié)轉(zhuǎn)移率高于15%,而同屬于高度惡性腫瘤的腺樣囊性癌與肌上皮癌的轉(zhuǎn)移率較低;肉瘤類惡性腫瘤的整體淋巴結(jié)轉(zhuǎn)移率很低,僅為4.9%。結(jié)論:建議對c N0上頜鱗狀細胞癌患者行選擇性頸淋巴結(jié)清掃術(shù),對于非特異性腺癌、低分化黏液表皮樣癌、導(dǎo)管癌等高度惡性腺源性癌患者可行選擇性頸淋巴結(jié)清掃術(shù),對于肉瘤類患者可對頸部進行密切觀察。
[Abstract]:Objective: to investigate and compare the cervical lymph node metastasis rate of maxillary malignant tumors in clinically negative neck lymph nodec N0 in different pathological types, and to provide a reference for the management of cervical lymph nodes in these patients.Methods: 277 cases of c N0 maxillary malignant tumor with complete clinical and follow-up data from 1990 to 2010 were selected to record the status of cervical lymph node metastasis and related clinical information.To study the regularity of cervical lymph node metastasis in maxillary malignant tumors and analyze the related factors of lymph node metastasis by SPSS 19.0 software.Results the overall incidence of cervical lymph node metastasis in 277 patients with c N0 maxillary malignant tumor was 15.543 / 2770.The cervical lymph node metastasis rate of maxillary squamous cell carcinoma was 33.0 because of its strong lymph node metastasis, and the overall metastasis rate of adenogenic carcinoma was lower.The lymph node metastasis rate of highly malignant adenogenic carcinoma was significantly higher than that of middle and low grade malignant adenogenic carcinoma (P < 0.037, respectively), including non-specific adenocarcinoma and poorly differentiated mucoepidermoid carcinoma.The cervical lymph node metastasis rate of ductal carcinoma was higher than that of 15 tumors, while that of adenoid cystic carcinoma and myoepithelial carcinoma, which were both highly malignant tumors, was lower, while the overall lymph node metastasis rate of sarcomatoid malignant tumors was very low, which was only 4.9.Conclusion: selective neck lymph node dissection is recommended for patients with c N0 maxillary squamous cell carcinoma, and can be used for non-specific adenocarcinoma, poorly differentiated mucoepidermoid carcinoma, ductal carcinoma and other highly malignant adenogenic carcinomas.For sarcomatous patients, the neck can be closely observed.
【作者單位】： 北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院口腔頜面外科口腔數(shù)字化醫(yī)療技術(shù)和材料國家工程實驗室口腔數(shù)字醫(yī)學(xué)北京市重點實驗室;北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院第二門診部口腔頜面外科口腔數(shù)字化醫(yī)療技術(shù)和材料國家工程實驗室口腔數(shù)字醫(yī)學(xué)北京市重點實驗室;
【基金】：國家科技支撐計劃項目(2014BAI04B06)資助~~
【分類號】：R739.8

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