耳部高危鳞状细胞癌——前哨淋巴结活检的潜在作用
High-risk squamous cell carcinoma of the ear - A potential role for sentinel node biopsy.
作者信息
Beecher Suzanne, Wrafter Paula F, Joyce Cormac W, Regan Padraic J, Kelly Jack L
机构信息
Department of Plastic and Reconstructive Surgery, University College Hospital, Galway, National University of Ireland, Galway.
出版信息
Head Neck. 2017 Sep;39(9):1840-1844. doi: 10.1002/hed.24843. Epub 2017 Jun 22.
BACKGROUND
Squamous cell carcinomas (SCCs) of the external ear have a significant rate of metastasis. The purpose of this study was to present analyzed factors associated with auricular SCC metastasis in order to identify a group that may benefit from sentinel lymph node biopsy (SLNB).
METHODS
We performed a retrospective review of all operable SCCs between 2009 and 2014. The association between high-risk features and metastasis were analyzed.
RESULTS
One hundred eighty-nine auricular SCCs were excised. Local recurrence was noted in 11% and 9.5% developed metastases. Cartilage, perineural, and lymphovascular invasion were significantly associated with metastasis, as were increased tumor depth and diameter (P < .001). All patients with metastasis developed nodal disease.
CONCLUSION
Factors, including poor differentiation, perineural, cartilage, and lymphovascular invasion, are associated with auricular SCC metastasis. Patients with 2 or more high-risk features may benefit from SLNB in order to identify and treat early nodal disease and possibly reduce the risk of further spread.
背景
外耳道鳞状细胞癌（SCC）有较高的转移率。本研究旨在分析与耳廓SCC转移相关的因素，以确定可能从前哨淋巴结活检（SLNB）中获益的人群。
方法
我们对2009年至2014年间所有可手术切除的SCC进行了回顾性研究。分析了高危特征与转移之间的关联。
结果
共切除189例耳廓SCC。局部复发率为11%，9.5%发生转移。软骨、神经周围和淋巴管浸润与转移显著相关，肿瘤深度和直径增加也与转移显著相关（P <.001）。所有发生转移的患者均出现淋巴结疾病。
结论
包括低分化、神经周围、软骨和淋巴管浸润等因素与耳廓SCC转移相关。具有2个或更多高危特征的患者可能从前哨淋巴结活检中获益，以便识别和早期治疗淋巴结疾病，并可能降低进一步扩散的风险。
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