口腔癌下颌下腺侵犯及保留腺体的颈部清扫术的可行性
Submandibular gland invasion and feasibility of gland-sparing neck dissection in oral cavity carcinoma.
作者信息
Cakir Cetin A, Dogan E, Ozay H, Kumus O, Erdag T K, Karabay N, Sarioglu S, Ikiz A O
机构信息
Department of ENT,Faculty of Medicine,Dokuz Eylul University,Izmir,Turkey.
Department of Radiology,Dokuz Eylul University,Izmir,Turkey.
出版信息
J Laryngol Otol. 2018 May;132(5):446-451. doi: 10.1017/S0022215118000592. Epub 2018 May 3.
OBJECTIVE
This study investigated the incidence and routes of submandibular gland involvement in oral cavity carcinoma to determine the feasibility of submandibular gland sparing neck dissection.
METHODS
The records of 155 patients diagnosed with oral cavity squamous cell carcinoma, with a total of 183 neck specimens, including those involving level I, were reviewed retrospectively.
RESULTS
Submandibular gland involvement, via direct invasion from the anatomical proximity of T4a tumours, was evident in two patients. The floor of mouth location, either primarily or as an extension of the primary tumour, was the only risk factor for submandibular gland involvement in oral cavity carcinoma (p = 0.042). Tumour location, clinical and pathological tumour (T) and nodal (N) stages, and radiological suspicion of mandible invasion, were not found to be statistically relevant (p > 0.05).
CONCLUSION
The results suggest the feasibility of preserving the submandibular gland in early stage oral cavity carcinoma unless the tumour is located in, or extends to, the floor of mouth.
目的
本研究调查口腔癌患者下颌下腺受累的发生率及途径，以确定保留下颌下腺的颈部清扫术的可行性。
方法
回顾性分析155例诊断为口腔鳞状细胞癌患者的记录，共183份颈部标本，包括累及I区的标本。
结果
2例患者因T4a肿瘤的解剖位置直接侵犯导致下颌下腺受累。口腔底部位置，无论是原发灶还是作为原发肿瘤的延伸，是口腔癌患者下颌下腺受累的唯一危险因素（p = 0.042）。未发现肿瘤位置、临床和病理肿瘤（T）及淋巴结（N）分期以及下颌骨侵犯的影像学怀疑具有统计学相关性（p > 0.05）。
结论
结果表明，在早期口腔癌中，除非肿瘤位于或延伸至口腔底部，否则保留下颌下腺是可行的。
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