Golubović Mileta, Asanin Bogdan, Jelovac Drago, Petrović Milan, Antunović Marija
Medicinski fakultet, Klinicki centar Crne Gore, Centar za patologiju i sudsku medicinu, Podgorica, Crna Gora.
Vojnosanit Pregl. 2010 Jan;67(1):19-24. doi: 10.2298/vsp1001019g.
BACKGROUND/AIM: The most common malignancy of the lip is squamous cell carcinoma (SCC). In our population, according to epidemiological data, almost a half of all (45%) SCC of oral mucous tissue spreads over the lower and upper lip. The aim of this study was to estimate prognostic importance of histopathologic characteristics--histologic grade, nuclear grade and tumor size in relation to the appearance of lymph node metastases and relapse in SCC of the lip.
In the retrospective-prospective study 70 cases of lower and upper lip SCC were analyzed. They were diagnosed from 2002 to 2006 in the Clinic of Maxillofacial Surgery, Clinical Center of Montenegro. The data about localization of the carcinomas, histopathologic characteristics and lymph node status were taken from medical files of the patients. The patients were followed up in a 3-year period and the disease relapse or/and metastatic disease appearance were registereds.
There was statistically significant difference in tumor size among the patients with and without disease relapse (p = 0.027). Logistic regression analysis showed that the tumor size is a statistically significant factor (R = 0.186; p = 0.011) for the appearance of regional lymph node metastases. Relative risk [exp (B)] for the appearance of regional lymph node metastases in relation to tumor size was 2.807.
Histologic and nuclear grade of lip SCC are not prognostic factors for the appearance of the disease relapse and regional lymph node metastases. Tumor size is a predictive factor of the relapse appearance, as well as for lymph node metastases appearance. In clinical practice, tumor size is a factor that classifies patients with lip SCC into the groups of higher and smaller risk of relapse appearance and for lymph node metastases appearance. Our results suggest that, risk for lymph node metastases appearance increases 2.8 times with increasing of the tumor size over 2 cm in diameter.
背景/目的：唇部最常见的恶性肿瘤是鳞状细胞癌（SCC）。在我们的人群中，根据流行病学数据，口腔黏膜组织中几乎一半（45%）的SCC扩散至上下唇。本研究的目的是评估组织病理学特征——组织学分级、核分级和肿瘤大小对唇部SCC出现淋巴结转移和复发的预后重要性。
在这项回顾性-前瞻性研究中，分析了70例上下唇SCC病例。这些病例于2002年至2006年在黑山临床中心颌面外科诊所被诊断。关于癌灶定位、组织病理学特征和淋巴结状态的数据取自患者的医疗档案。对患者进行了3年的随访，并记录疾病复发或/和转移性疾病的出现情况。
有疾病复发和无疾病复发的患者在肿瘤大小上存在统计学显著差异（p = 0.027）。逻辑回归分析表明，肿瘤大小是区域淋巴结转移出现的统计学显著因素（R = 0.186；p = 0.011）。相对于肿瘤大小，区域淋巴结转移出现的相对风险[exp (B)]为2.807。
唇部SCC的组织学和核分级不是疾病复发和区域淋巴结转移出现的预后因素。肿瘤大小是复发出现以及淋巴结转移出现的预测因素。在临床实践中，肿瘤大小是将唇部SCC患者分为复发出现和淋巴结转移出现风险较高和较低组别的一个因素。我们的结果表明，当肿瘤直径超过2 cm时，淋巴结转移出现的风险随着肿瘤大小的增加而增加2.8倍。
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