Szybiak Bartosz, Trzeciak Paweł, Golusiński Wojciech
Head and Neck Surgery and Laryngological Oncology Department, Greater Poland Cancer Centre, Poland.
Cancer Pathology Department, Greater Poland Cancer Centre, Poland.
Rep Pract Oncol Radiother. 2012 Jul 17;17(6):319-23. doi: 10.1016/j.rpor.2012.06.001. eCollection 2012.
The aim is to find out why the rate of recurrence of tongue and floor of the mouth cancer is so high despite radical surgical treatment combined with radiochemotherapy.
Oropharyngeal cancer is the second most common head and neck cancer in Poland. Tongue cancers account for 40% of all oral cavity tumours. A frequent reason for a failure in treatment of tongue and floor of the mouth cancers is local recurrence. Based on that examination, cancer treatment can be precisely planned.
The study comprised a group of 56 tongue and floor of the mouth cancer patients. 9 patients who showed local recurrence were given an extended histopathological examination. The infiltration of the vessels, nerves and muscles was examined. The examination also checked the largest dimension of the tumour, the greatest depth of invasion from the mucous membrane, invasive front of the cancer, vessel embolisms, intra- and perineural infiltrations in the cancer invasive front. Tumour aggressiveness was assessed according to M. Brandwein-Gensler.
In five patients, primary tumours were found to be histologically aggressive as indicated by the infiltration of the vessels, nerves and muscles. Tumours which penetrate these structures were characterized with peri- and intraneural infiltration and were correlated with the depth of invasion from the mucous membrane, the occurrence of embolisms, and a high risk assessment as proposed by M. Brandwein-Gensler.
The progression of cancer depends strongly on histopathological traits. The incidence of penetration of the vessels, nerves and muscles correlates with aggressiveness of the tumour front.
旨在找出尽管采用了根治性手术联合放化疗，舌癌和口底癌的复发率为何仍如此之高的原因。
口咽癌是波兰第二常见的头颈癌。舌癌占所有口腔肿瘤的40%。舌癌和口底癌治疗失败的常见原因是局部复发。基于该检查，可精确规划癌症治疗方案。
该研究纳入了56例舌癌和口底癌患者。对9例出现局部复发的患者进行了扩展的组织病理学检查。检查了血管、神经和肌肉的浸润情况。该检查还检查了肿瘤的最大尺寸、从黏膜的最大浸润深度、癌的浸润前沿、血管栓塞、癌浸润前沿的神经内和神经周围浸润情况。根据M. Brandwein-Gensler评估肿瘤的侵袭性。
在5例患者中，原发性肿瘤在组织学上表现出侵袭性，表现为血管、神经和肌肉的浸润。穿透这些结构的肿瘤具有神经周围和神经内浸润的特征，并与从黏膜的浸润深度、栓塞的发生以及M. Brandwein-Gensler提出的高风险评估相关。
癌症的进展在很大程度上取决于组织病理学特征。血管、神经和肌肉的穿透发生率与肿瘤前沿的侵袭性相关。
