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口腔癌的边缘控制切除术活检。

Excisional biopsy with margin control for oral cancers.

机构信息

Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.

出版信息

Head Neck. 2010 Nov;32(11):1528-33. doi: 10.1002/hed.21359.

Abstract

BACKGROUND

This study was undertaken to show how an excisional biopsy procedure can be used to remove the entire specimen for oral lesions with difficult diagnoses.

METHODS

We retrospectively reviewed 52 cases with 56 oral lesions either suspected to be malignant or with a preliminary controversial diagnosis. These were treated by excisional biopsy with frozen section intraoperatively between January 2003 and June 2008.

RESULTS

Twenty-eight of 56 lesions were diagnosed with malignancy. We found a high underdiagnosis rate (7 of 12) in patients who had a preliminary controversial diagnosis. Twenty-one patients without preoperative biopsy were diagnosed to have malignancies. Of the 28 malignant cases, all surgical margins were negative. Neck ultrasound scans with fine-needle aspiration cytology was carried out and no patient demonstrated simultaneous neck metastasis. One patient died of locoregional recurrence. Two patients died of a second primary cancer.

CONCLUSION

Excisional biopsy with margin control is useful both in diagnosis and treatment of oral cancers.

摘要

背景

本研究旨在展示如何通过切除活检术来切除具有诊断困难的口腔病变的整个标本。

方法

我们回顾性分析了 2003 年 1 月至 2008 年 6 月期间,52 例疑似恶性或初步诊断有争议的 56 例口腔病变患者。这些患者均采用切除活检术,术中进行冷冻切片。

结果

56 个病变中有 28 个被诊断为恶性。我们发现术前有争议诊断的患者有很高的漏诊率(12 例中有 7 例)。21 例未行术前活检的患者被诊断为恶性。28 例恶性病例中,所有手术切缘均为阴性。对所有患者进行了颈部超声扫描和细针抽吸细胞学检查,无患者显示同时存在颈部转移。1 例患者死于局部区域复发。2 例患者死于第二原发癌。

结论

带切缘控制的切除活检术对口腔癌的诊断和治疗均有价值。

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