Wu Kailiu, Yang Xi, Li Liwen, Ruan Min, Liu Wei, Lu Wei, Zhang Chenping, Li Siyi
Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Mol Neurobiol. 2016 Jul;53(5):2920-2926. doi: 10.1007/s12035-015-9175-5. Epub 2015 Apr 25.
The objectives of this study were to analyze the regional characteristics of the cervical lymph node metastasis and to investigate the factors associated with the risk of lymph node involvement. One hundred seventy-one patients suffering from early primary squamous cell carcinoma (SCC) of the tongue (cT1-2N0) were enrolled. Gender, age, growth site, T stage, histological grade, and neurovascular invasion were statistically analyzed by K-M survival analysis and Cox multivariate analysis to evaluate the relationship between the factors and the neck lymph node metastasis. Of the 171 cases divided into the neck dissection group and observation group, 40 ended up with lymph node metastasis, of which 17 were metastasized to level I, 27 to level II, 10 to level III, 2 to level IV, and 1 to level V. Histological grade and neurovascular invasion were significantly associated with lymph node involvement in univariate and multivariate analyses. Age distribution was found to be significantly associated with the lymph node metastasis in multivariate analysis. The metastasis of early tongue SCC has a certain regularity at different sites. Age was not a critical risk factor for cervical lymph node metastasis after surgery. Tumor size was suspected to exert a negative effect on metastasis by influencing tumor invasion. Histological grade and neurovascular invasion were significantly associated with the risk of cervical lymph node metastasis of early tongue SCC.
本研究的目的是分析颈淋巴结转移的区域特征，并探究与淋巴结受累风险相关的因素。纳入了171例患有早期舌原发性鳞状细胞癌（SCC，cT1-2N0）的患者。通过K-M生存分析和Cox多因素分析对性别、年龄、生长部位、T分期、组织学分级和神经血管侵犯进行统计学分析，以评估这些因素与颈部淋巴结转移之间的关系。在分为颈清扫组和观察组的171例病例中，40例最终发生了淋巴结转移，其中17例转移至I区，27例转移至II区，10例转移至III区，2例转移至IV区，1例转移至V区。在单因素和多因素分析中，组织学分级和神经血管侵犯与淋巴结受累显著相关。在多因素分析中，发现年龄分布与淋巴结转移显著相关。早期舌SCC的转移在不同部位有一定规律。年龄不是术后颈淋巴结转移的关键危险因素。怀疑肿瘤大小通过影响肿瘤侵袭对转移产生负面影响。组织学分级和神经血管侵犯与早期舌SCC颈淋巴结转移风险显著相关。
