Nason R W, Castillo N B, Sako K, Shedd D P
Department of Head and Neck Surgery, Roswell Park Memorial Institute, Buffalo, New York 14263.
World J Surg. 1990 Sep-Oct;14(5):606-9. doi: 10.1007/BF01658802.
A semiquantitative assessment of multiple histological parameters was applied retrospectively to 66 patients with stage I and II squamous cell carcinoma of the floor of the mouth to determine if prognostic information relative to cervical node metastases could be obtained. Three parameters relating to the tumor cell population and 5 describing the tumor-host interface were evaluated on a point scale from 1 to 3 with the highest score going to the most threatening characteristic. Twenty of the 66 patients had either occult metastases identified by elective lymphadenectomy (n = 11) or developed metastases to the neck (n = 9). There was no correlation between traditional histological grading as recorded at the time of presentation and the frequency of cervical metastases (p greater than 0.05). Histological reevaluation defined 3 groups of patients with low (less than 14), moderate (14-16), and high scores (greater than 16) with an incidence of cervical metastases of 5/39 (12.8%), 6/17 (35.3%), and 9/10 (90%), respectively (p less than 0.001). The results suggest that microscopic grading could be a useful adjunct to the present TNM staging system in selecting patients likely to benefit from elective treatment of the neck.
对66例I期和II期口底鳞状细胞癌患者的多项组织学参数进行了回顾性半定量评估，以确定是否能够获得与颈部淋巴结转移相关的预后信息。对与肿瘤细胞群体相关的3项参数以及描述肿瘤-宿主界面的5项参数进行了评估，评分范围为1至3分，得分越高表明特征越具威胁性。66例患者中有20例通过选择性淋巴结清扫术发现隐匿性转移（n = 11）或出现颈部转移（n = 9）。就诊时记录的传统组织学分级与颈部转移频率之间无相关性（p>0.05）。组织学重新评估将患者分为3组，低评分组（小于14分）、中等评分组（14 - 16分）和高评分组（大于16分），颈部转移发生率分别为5/39（12.8%）、6/17（35.3%）和9/10（90%）（p<0.001）。结果表明，在选择可能从颈部选择性治疗中获益的患者时，微观分级可能是当前TNM分期系统的有用辅助手段。
