Yoshida Kazuhide, Kashima Kenji, Suenaga Satoshi, Nomi Nozomi, Shuto Jun, Suzuki Masashi
Department of Otolaryngology, Faculty of Medicine, Oita University, Oita, Japan.
Acta Otolaryngol. 2005 Jun;125(6):654-8. doi: 10.1080/00016480410025252.
These results indicate that extensive, multiple cervical micrometastases occurred from an early stage in patients with T2N0 tongue cancer. The presence of micrometastases suggests the necessity of preventive neck dissection for Level I-IV nodes as a radical treatment.
Cervical lymph node metastases occur with a relatively high frequency in patients with T2N0 squamous cell carcinoma of the tongue, and control of the metastases greatly influences the prognosis of patients. In this study, micrometastases in the cervical lymph nodes were investigated to clarify the necessity and required extent of preventive neck dissection.
We investigated micrometastases in 24 subjects who had previously been diagnosed with T2N0 tongue cancer. We performed immunostaining with anti-cytokeratin antibody cocktail AE1/AE3 of sections of 401 paraffin-embedded lymph nodes obtained from these patients.
Micrometastases were observed in 14 patients (58%) and were most abundant in Level II nodes (n=11; 46%). Micrometastases were observed in the Level IV nodes of 3 patients (13%), and upstaging to pN2b occurred in 7 patients (29%).
这些结果表明，T2N0期舌癌患者从疾病早期就已出现广泛、多发的颈部微转移。微转移的存在提示，作为根治性治疗手段，对Ⅰ-Ⅳ级淋巴结进行预防性颈清扫很有必要。
T2N0期舌鳞状细胞癌患者发生颈部淋巴结转移的频率相对较高，而对转移灶的控制对患者预后有很大影响。本研究通过调查颈部淋巴结微转移情况，以明确预防性颈清扫的必要性及所需范围。
我们对24例既往诊断为T2N0期舌癌的患者进行了微转移情况调查。我们使用抗细胞角蛋白抗体混合物AE1/AE3对这些患者的401个石蜡包埋淋巴结切片进行免疫染色。
14例患者（58%）观察到微转移，其中Ⅱ级淋巴结微转移最为多见（n = 11；46%）。3例患者（13%）的Ⅳ级淋巴结观察到微转移，7例患者（29%）分期上调至pN2b。
