Karakida Kazunari, Ota Yoshihide, Aoki Takayuki, Yamazaki Hiroshi, Tsukinoki Keiichi
Department of Oral Surgery, Division of Functional Reconstruction, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Tokai J Exp Clin Med. 2002 Sep;27(3):65-71.
Occult metastasis of the cervical lymph nodes was examined as a prognostic factor for T1 and T2 tongue carcinoma. The T classification and thickness of tongue carcinoma as well as histological malignancy were assessed respectively as clinical and histopathological factors related to metastasis. Sixty-eight patients who had undergone partial glossectomy for the treatment of T1 or T2 tongue carcinoma were studied. Occult metastasis of the cervical lymph nodes occurred in 15 out of 68 patients (22.1%). It occurred in 18.4% of T1 patients and 26.7% of T2 patients. Although the incidence of metastasis was higher in patients with larger tumors, a significant difference was not observed. Examination of the thickness of the tongue tumors revealed a mean value of 3.5 mm in patients without metastasis versus 5.5 mm in patients with metastasis, which was a significant difference. Examination of histological malignancy showed a significant correlation between the pattern of invasion and the incidence of occult metastasis to the cervical lymph nodes. There was a significant difference between the total score of the group without occult metastasis (12.8 points) and that of the group with metastasis (14.4 points). Improvement of the prognosis might be possible through elective neck dissection if occult metastasis to the cervical lymph nodes could be predicted.
对颈淋巴结隐匿性转移作为T1和T2期舌癌的预后因素进行了研究。将舌癌的T分类、厚度以及组织学恶性程度分别评估为与转移相关的临床和组织病理学因素。对68例因T1或T2期舌癌接受部分舌切除术的患者进行了研究。68例患者中有15例（22.1%）发生了颈淋巴结隐匿性转移。T1期患者的发生率为18.4%，T2期患者为26.7%。虽然肿瘤较大的患者转移发生率较高，但未观察到显著差异。对舌肿瘤厚度的检查显示，无转移患者的平均值为3.5mm，有转移患者为5.5mm，这是一个显著差异。组织学恶性程度检查显示，浸润模式与颈淋巴结隐匿性转移发生率之间存在显著相关性。无隐匿性转移组的总分（12.8分）与有转移组的总分（14.4分）之间存在显著差异。如果能够预测颈淋巴结隐匿性转移，通过选择性颈清扫术可能改善预后。
