Keski-Säntti Harri, Atula Timo, Tikka Jarkko, Hollmén Jaakko, Mäkitie Antti A, Leivo Ilmo
Department of Otorhinolaryngology Head and Neck Surgery, Helsinki University Central Hospital, P.O. Box 220, FIN - 00029 HUCH, Helsinki, Finland.
Oral Oncol. 2007 Nov;43(10):1007-13. doi: 10.1016/j.oraloncology.2006.11.015. Epub 2007 Feb 15.
The clinical course of early squamous cell carcinoma of oral tongue (OTSCC) is unpredictable and various histopathologic parameters of the primary tumour have been suggested as prognostic factors to be used in clinical decision-making. We reviewed clinicopathologic data of 73 patients diagnosed with Stage I-II OTSCC. Predictive value of pathological T-stage, depth of infiltration, grade, and mode of invasion with respect to local recurrences, occult cervical metastases, and disease specific survival (DSS) was analysed. Depth of infiltration and pT-stage significantly predicted occult nodal disease, while only pT-stage predicted local recurrence. Specific cut-off value for depth of infiltration separating high-risk and low-risk patients was not found. Significant correlations between the histopathologic parameters and DSS were not found. We conclude that depth of infiltration predicted occult nodal disease but its value in clinical decision-making is limited because of poor specificity when using a cut-off value that offers reasonable sensitivity for finding the patients with occult nodal disease. The risk for occult metastases and local recurrence was high in patients with pT2 tumours.
口腔舌部早期鳞状细胞癌(OTSCC)的临床病程难以预测,原发性肿瘤的各种组织病理学参数已被视为用于临床决策的预后因素。我们回顾了73例诊断为Ⅰ - Ⅱ期OTSCC患者的临床病理数据。分析了病理T分期、浸润深度、分级及浸润方式对局部复发、隐匿性颈淋巴结转移和疾病特异性生存(DSS)的预测价值。浸润深度和pT分期显著预测隐匿性淋巴结疾病,而只有pT分期能预测局部复发。未发现区分高危和低危患者的浸润深度的特定临界值。未发现组织病理学参数与DSS之间存在显著相关性。我们得出结论,浸润深度可预测隐匿性淋巴结疾病,但由于在使用对发现隐匿性淋巴结疾病具有合理敏感性的临界值时特异性较差,其在临床决策中的价值有限。pT2期肿瘤患者发生隐匿性转移和局部复发的风险较高。