论文部分内容阅读
目的研究舌鳞状细胞癌患者发生患侧颈部淋巴结LevelⅣ转移的风险因素。方法收集我院口腔科2008年1月至2015年6月确诊的舌鳞状细胞癌患者165例(170侧),同期行颈淋巴结清扫术及原发灶手术治疗,应用卡方检验及Logistic回归分析LevelⅣ转移的影响因素,分析变量包括年龄、性别、癌生长方式、T分期、病理分级、LevelⅢ转移、Level I~Ⅲ的转移阳性淋巴结分区个数、Level I~Ⅲ的转移淋巴结个数。结果颈淋巴结转移患者98例(101侧),LevelⅣ转移14侧(14/170,8.24%),LevelⅣ跳跃性转移2侧(2/170,1.18%)。卡方检验表明,Level I~Ⅲ的转移阳性淋巴结分区个数(≥2)、Level I~Ⅲ的转移淋巴结个数(≥3)、LevelⅢ发生转移均是独立的风险因素(P<0.01);Logistic回归分析显示,只有LevelⅢ发生转移为LevelⅣ转移的风险因素(P<0.01)。结论发生LevelⅢ转移的舌癌患者LevelⅣ转移的风险增加。
Objective To study the risk factors of Level Ⅳ metastasis of ipsilateral cervical lymph nodes in patients with tongue squamous cell carcinoma. Methods Totally 165 patients with squamous cell carcinoma of the tongue (170 sides) diagnosed in our department from January 2008 to June 2015 were enrolled in this study. The cervical lymph node dissection and primary lesion were treated by chi-square test and Logistic regression The influencing factors of Level Ⅳ metastasis were analyzed. The variables included age, gender, tumor growth pattern, T stage, pathological grade, Level Ⅲ metastasis, Level Ⅰ ~ Ⅲ metastatic lymph nodes and Level I ~ Ⅲ metastatic lymph nodes. Results 98 cases (101 sides) of cervical lymph node metastasis, 14 levels (14 / 170,8.24%) of Level Ⅳ metastasis, and 2 (170 / 18.1%) of LevelⅣ jump metastasis. The chi - square test showed that the number of metastatic positive lymph nodes (≥2), the number of metastatic lymph nodes (≥3) and the metastasis of Level Ⅲ in Level Ⅰ ~ Ⅲ were independent risk factors (P <0.01). Logistic regression analysis showed that only level Ⅲ metastasis was a risk factor for Level Ⅳ metastasis (P <0.01). Conclusions Patients with Level Ⅲ metastases have an increased risk of Level Ⅳ metastases.