硬腭和上颌牙槽鳞状细胞癌的颈部转移：一项为期10年的回顾性研究
Cervical metastases from squamous cell carcinoma of hard palate and maxillary alveolus: a retrospective study of 10 years.
作者信息
Yang Zinan, Deng Runzhi, Sun Guowen, Huang Xiaofeng, Tang Enyi
机构信息
Department of Oral and Maxillofacial Surgery, Stomatological Hospital Affiliated Medical School, Nanjing University, Nanjing, Jiangsu province, People's Republic of China; Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guangzhou Medical University, Guangzhou, Guangdong province, People's Republic of China.
出版信息
Head Neck. 2014 Jul;36(7):969-75. doi: 10.1002/hed.23398. Epub 2013 Sep 18.
BACKGROUND
The purpose of this study was to investigate the incidence of cervical metastasis in squamous cell carcinoma (SCC) of hard palate and maxillary alveolus and to define its impact factors.
METHODS
We conducted a retrospective study of patients surgically treated for SCC of hard palate and maxillary alveolus from 2002 to 2011. In situ hybridization was performed to detect high-risk human papillomavirus (HPV) infection.
RESULTS
The incidences of cervical metastasis and occult metastasis were 17.2% (11/64) and 9.8% (5/51), respectively. The pT classification and vascular invasion were correlated with cervical metastasis. Occult metastatic risk was significantly higher among patients with pT4. Presence of positive nodes impaired prognosis significantly.
CONCLUSION
SCC of hard palate and maxillary alveolus has nonnegligible incidences of both overall and occult metastasis, which were highly associated with pT classification. We recommend routine, synchronous elective neck dissection for T4 lesions, whereas observation is an alternative for T1 to T3 lesions.
背景
本研究旨在调查硬腭和上颌牙槽鳞状细胞癌（SCC）颈部转移的发生率，并确定其影响因素。
方法
我们对2002年至2011年因硬腭和上颌牙槽SCC接受手术治疗的患者进行了一项回顾性研究。采用原位杂交检测高危人乳头瘤病毒（HPV）感染。
结果
颈部转移和隐匿性转移的发生率分别为17.2%（11/64）和9.8%（5/51）。pT分类和血管侵犯与颈部转移相关。pT4患者的隐匿性转移风险显著更高。阳性淋巴结的存在显著损害预后。
结论
硬腭和上颌牙槽SCC的总体转移和隐匿性转移发生率均不可忽视，且与pT分类高度相关。对于T4病变，我们建议常规同步选择性颈清扫术，而对于T1至T3病变，观察是一种替代方案。
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