Department of Clinical and Biological Sciences, University of Turin, Torino, Italy.
Oral Dis. 2011 Apr;17(3):298-303. doi: 10.1111/j.1601-0825.2010.01740.x. Epub 2010 Sep 23.
This study aimed to analyse a case series of microinvasive (tumour thickness <4 mm) stage I oral squamous cell carcinoma (OSCC), with an emphasis on the clinical features of the tumours.
In total, 32 microinvasive and 67 non-microinvasive stage I lesions, which had been surgically treated, were retrospectively studied and compared. The data analysed included gender, age, risk habits, clinical appearance, lesion site, symptoms, nodal involvement and outcome.
The clinical features of microinvasive lesions meant that, more often than not, they resembled premalignant lesions (P = 0.008), and diagnosis was mainly based on accurate clinical examination rather than the presence of symptoms (P = 0.029). During a median follow-up of 4.5 years, one nodal involvement and one cancer-related death were observed in patients with microinvasive lesions. A significantly higher (P = 0.044) level of nodal involvement was observed in the non-microinvasive lesion group.
Stage I OSCC has a favourable prognosis overall, but nodal recurrence is more common in non-microinvasive cancers. As microinvasive lesions tend to present clinically as premalignant lesions, accurate clinical examination is essential if misdiagnosis of early lesions is to be avoided.
本研究旨在分析一组浸润深度＜4mm 的Ⅰ期口腔鳞状细胞癌（OSCC）的病例系列，重点分析肿瘤的临床特征。
共回顾性研究了 32 例微浸润和 67 例非微浸润Ⅰ期病变，并对其进行了比较。分析的数据包括性别、年龄、风险习惯、临床外观、病变部位、症状、淋巴结受累和结果。
微浸润病变的临床特征意味着它们常常类似于癌前病变（P=0.008），诊断主要基于准确的临床检查而不是症状的存在（P=0.029）。在中位随访 4.5 年期间，微浸润病变组有 1 例淋巴结受累和 1 例与癌症相关的死亡。非微浸润病变组淋巴结受累的比例显著更高（P=0.044）。
Ⅰ期 OSCC 的总体预后良好，但非微浸润癌的淋巴结复发更为常见。由于微浸润病变在临床上往往表现为癌前病变，因此如果要避免对早期病变的误诊，准确的临床检查至关重要。
