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目的:研究早期舌鳞癌患者颌下腺转移的发生率,从而建立保留颌下腺的理论基础。方法:通过回顾性分析中山大学肿瘤防治中心1994年1月至2004年12月收治的152例早期舌鳞癌患者的临床资料。152例患者的发病年龄为20-75岁,中位年龄为55岁;男性92例,女性60例,男女比例约为1.5∶1,均为我院首诊的。其中肿瘤原发部位为,舌侧缘106例,舌腹32例,舌背:8例,舌腹+舌背6例。结果:152例患者行了颈部淋巴结清扫术(颌下腺全部切除),术后隐匿性淋巴结转移率为:16|152,其中Ⅰ区3例,Ⅱ区(9例)14例次,Ⅲ区3例次,Ⅳ区1例次,没有1例颌下腺受累。术后舌复发4例,口底复发2例颈部淋巴结转移25例咽旁转移1例,2例远处转移。至末次随访,38例亡,死于肿瘤29例,死于其他9例。结论:保留颌下腺在早期舌鳞癌当中是可行的,需要进一步的前瞻性研究来论证。
Objective: To study the incidence of submandibular gland metastasis in patients with early tongue squamous cell carcinoma so as to establish the theoretical basis for preserving the submandibular gland. Methods: The clinical data of 152 patients with early tongue squamous cell carcinoma who were admitted to Cancer Center of Sun Yat-sen University from January 1994 to December 2004 were retrospectively analyzed. 152 patients aged 20-75 years old, the median age of 55 years; 92 males and 60 females, male to female ratio of about 1.5: 1, are the first diagnosis of our hospital. The primary tumor site, 106 cases of lingual margin, tongue in 32 cases, tongue back: 8 cases, tongue + tongue back in 6 cases. Results: Fifty-two patients underwent neck lymph node dissection (submandibular gland resection). The rate of occult lymph node metastasis after operation was 16.152, of which 3 were in area Ⅰ, 14 in area Ⅱ (9 cases), 3 in area Ⅲ Cases, Ⅳ area 1 case times, no case of submandibular gland involvement. There were 4 cases of tongue recurrence, 2 cases of cervical lymph node metastasis in the floor of mouth, 25 cases of parapharyngeal metastasis in 1 case and 2 cases distant metastasis. To the last follow-up, 38 died, died of tumor in 29 cases, died of the other 9 cases. Conclusion: It is feasible to preserve the submandibular gland in early tongue squamous cell carcinoma, and further prospective studies are needed to prove it.