Guo Zhu-ming, Zeng Zong-yuan, Xia Liang-ping, Chen Fu-jin, Zhang Quan, Chen Wen-kuan
Department of Head and Neck Surgery, Cancer Center, Sun Yat-sen University, Guangzhou 510060, P. R. China.
Ai Zheng. 2002 Sep;21(9):979-82.
BACKGROUND & OBJECTIVE: There was little report on the rule of lymph node metastasis in the cancer of mouth floor. The aim of this study was to investigate the rule of lymph node metastasis and investigate the reasonable treatment.
A total of 79 cases with squamous carcinoma of mouth floor were included into this study retrospectively. The distributive difference of clinical and pathological positive lymph node was compared. The recurrent rate of the patients who were performed with radical neck dissection and supra-half-neck dissection in clinical positive lymph node group were compared with the recurrent rate of the patients who were preformed with radical neck dissection, supra-half-neck dissection, submandibular triangle dissection, and clinical observational group.
Clinical and pathological positive lymph node was found mainly in II region (61.8% and 40.0%, respectively), secondly in I and/or III region, and rarely in IV, V, and VI region. In clinical positive lymph node group, the recurrent rate of the patients who performed with radical cervical neck dissection was lower than supra-half-neck dissection, but without statistical significance (chi 2 = 3.403, P = 0.065). In clinical cervical negative lymph node group, the recurrent rates of the patients performed with supra-half-neck, submandibular triangle dissection, and in clinical observational group were 11.1% (1/9), 40.0% (2/5), and 23.5% (4/17), without statistical significance (chi 2 = 1.554, P = 0.46).
Lymph node metastasis of cancer of floor of mouth mainly distributes in I, II, III region; The patients with negative cervical lymph node should be performed lymph node dissection in I, II, III region (supra-half-neck).
关于口底癌淋巴结转移规律的报道较少。本研究旨在探讨口底癌淋巴结转移规律并探寻合理的治疗方法。
回顾性纳入79例口底鳞状细胞癌患者。比较临床及病理阳性淋巴结的分布差异。比较临床阳性淋巴结组中行根治性颈清扫术和半颈以上清扫术患者的复发率，以及与行根治性颈清扫术、半颈以上清扫术、下颌下三角清扫术患者及临床观察组的复发率。
临床及病理阳性淋巴结主要分布于Ⅱ区（分别为61.8%和40.0%），其次为Ⅰ区和/或Ⅲ区，极少见于Ⅳ、Ⅴ和Ⅵ区。临床阳性淋巴结组中，行根治性颈清扫术患者的复发率低于半颈以上清扫术患者，但无统计学意义（χ² = 3.403，P = 0.065）。临床颈淋巴结阴性组中，行半颈以上清扫术、下颌下三角清扫术患者及临床观察组的复发率分别为11.1%（1/9）、40.0%（2/5）和23.5%（4/17），无统计学意义（χ² = 1.554，P = 0.46）。
口底癌淋巴结转移主要分布于Ⅰ、Ⅱ、Ⅲ区；颈淋巴结阴性患者应行Ⅰ、Ⅱ、Ⅲ区（半颈以上）淋巴结清扫术。
