上消化道鳞状细胞癌的颈部淋巴结转移：包膜外扩散和软组织沉积的意义
Cervical node metastases in squamous cell carcinoma of the upper aerodigestive tract: the significance of extracapsular spread and soft tissue deposits.
作者信息
Jose Jemy, Coatesworth Andrew P, Johnston Colin, MacLennan Ken
机构信息
Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, Great George Street, Leeds, United Kingdom.
出版信息
Head Neck. 2003 Jun;25(6):451-6. doi: 10.1002/hed.10214.
BACKGROUND
Literature regarding the prognostic significance of extracapsular spread and soft tissue deposits in cervical lymph node metastases of squamous cell carcinoma of the upper aerodigestive tract shows variable results.
METHODS
We analyzed 215 prospectively collected neck dissections from 155 patients with upper aerodigestive tract squamous cell carcinoma to assess the prevalence of extracapsular spread and soft tissue deposits and to assess their effect on survival.
RESULTS
Both extracapsular spread and soft tissue deposits significantly reduced survival (actuarial and recurrence free) compared with pN0 necks (p <.001) and pN+ve necks without extracapsular spread (p <.0025). There was no statistically significant difference between pN+ve necks without soft tissue deposits or extracapsular spread compared with those with pN0 necks (p =.24). Multivariate analysis revealed comparable results.
CONCLUSIONS
Microscopic and macroscopic extracapsular spread and soft tissue deposits are of prognostic significance for survival and recurrence-free survival in patients with upper aerodigestive tract squamous cell carcinoma.
背景
关于上呼吸道消化道鳞状细胞癌颈部淋巴结转移中包膜外扩散和软组织沉积的预后意义的文献显示结果不一。
方法
我们分析了155例上呼吸道消化道鳞状细胞癌患者前瞻性收集的215例颈部清扫标本，以评估包膜外扩散和软组织沉积的发生率，并评估它们对生存的影响。
结果
与pN0颈部（p<.001）和无包膜外扩散的pN+颈部（p<.0025）相比，包膜外扩散和软组织沉积均显著降低了生存率（精算生存率和无复发生存率）。无软组织沉积或包膜外扩散的pN+颈部与pN0颈部相比，差异无统计学意义（p=.24）。多变量分析显示了类似的结果。
结论
微观和宏观的包膜外扩散及软组织沉积对上呼吸道消化道鳞状细胞癌患者的生存和无复发生存具有预后意义。
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