Hori Yukiko, Kubota Akira, Yokose Tomoyuki, Furukawa Madoka, Matsushita Takeshi, Takita Morihito, Mitsunaga Sachiyo, Mizoguchi Nobutaka, Nonaka Tetsuo, Nakayama Yuko, Oridate Nobuhiko
Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.
Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
Head Neck Pathol. 2017 Dec;11(4):477-486. doi: 10.1007/s12105-017-0814-1. Epub 2017 Apr 3.
In clinical N0 early oral tongue carcinoma, treatment of occult lymph node metastasis is controversial. The purpose of this study was to assess the histopathological risk factors for predicting late lymph node metastasis in early oral tongue carcinoma. We retrospectively reviewed 48 patients with early oral tongue squamous cell carcinoma. Associations between the histopathological factors (depth of tumor, differentiation, blood vessel invasion, lymphatic invasion, and tumor budding) and late lymph metastasis were analyzed. Although the univariate analysis identified blood vessel invasion, lymphatic invasion, and high-grade tumor budding as predictive factors for neck recurrence (p < 0.001), the Cox proportional hazards model identified high-grade tumor budding as an independent predictive factor (p < 0.01). The combination of a tumor depth ≥ 3 mm and high-grade tumor budding yielded high diagnostic accuracy. Tumor depth and budding grade were identified as histopathological risk factors for late neck recurrence in clinical N0 early oral tongue carcinoma.
在临床N0期早期口腔舌癌中，隐匿性淋巴结转移的治疗存在争议。本研究的目的是评估早期口腔舌癌中预测晚期淋巴结转移的组织病理学危险因素。我们回顾性分析了48例早期口腔舌鳞状细胞癌患者。分析了组织病理学因素（肿瘤深度、分化程度、血管侵犯、淋巴管侵犯和肿瘤芽生）与晚期淋巴结转移之间的相关性。单因素分析确定血管侵犯、淋巴管侵犯和高级别肿瘤芽生为颈部复发的预测因素（p < 0.001），而Cox比例风险模型确定高级别肿瘤芽生为独立预测因素（p < 0.01）。肿瘤深度≥3 mm与高级别肿瘤芽生相结合具有较高的诊断准确性。肿瘤深度和芽生分级被确定为临床N0期早期口腔舌癌晚期颈部复发的组织病理学危险因素。
