Yang Wenli, Sun Minglei, Jie Qiaoyan, Zhou Haixia, Zhang Peng, Zhu Juanfang
Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2020 Apr 7;10:471. doi: 10.3389/fonc.2020.00471. eCollection 2020.
Accurate predictors for occult metastasis in cT1-2N0 tongue squamous cell carcinoma (SCC) remains scarce, the main goal in current study was to evaluate whether there is significant association between lingual lymph node (LLN) metastasis and occult lymph node metastasis as well as whether there is prognostic value of LLN metastasis in early stage tongue SCC. Patients with surgically treated primary cT1-2N0 tongue SCC were prospectively enrolled from January 2010 to December 2018. LLNs were dissected independently for pathologic analysis. The main study endpoints were locoregional control survival (LRC) and disease-specific survival (DSS). The Chi-square test and multivariate regression analysis were used to assess the predictors for occult metastasis. The Kaplan-Meier approach and Cox model were used to analyze the potential prognostic factors. A total of 317 patients were enrolled for analysis. Eighty-eight patients had occult metastasis with a prevalence of 27.8%. LLNs presented in 89 patients, in which 43 patients had LLN metastasis. In the 43 patients with positive LLNs, 20 patients had occult metastasis, in 274 patients with negative LLNs or no LLNs, 68 patients had occult metastasis, the difference was significant ( = 0.012). Further multivariate regression analysis confirmed the independence of LLN metastasis in predicting the occult metastasis. In patients without LLNs, the 5-year LRC rate was 79%, in patients with negative LLNs, the 5-year LRC rate was 78%, in patients with positive LLNs, the 5-year LRC rate was 62%, the difference was significant ( = 0.024). In patients without LLNs, the 5-year DSS rate was 84%, in patients with negative LLNs, the 5-year DSS rate was 74%, in patients with positive LLNs, the 5-year DSS rate was 51%, the difference was significant ( < 0.001), further Cox model confirmed the independence of LLN metastasis in affecting the LRC and DSS. LLN metastasis is significantly associated with occult neck lymph node metastasis, and decrease the LRC and DSS in early stage tongue SCC.
cT1-2N0期舌鳞状细胞癌（SCC）隐匿性转移的准确预测指标仍然匮乏，本研究的主要目的是评估舌淋巴结（LLN）转移与隐匿性淋巴结转移之间是否存在显著关联，以及LLN转移在早期舌SCC中是否具有预后价值。2010年1月至2018年12月前瞻性纳入接受手术治疗的原发性cT1-2N0期舌SCC患者。独立解剖LLN进行病理分析。主要研究终点为局部区域控制生存（LRC）和疾病特异性生存（DSS）。采用卡方检验和多因素回归分析评估隐匿性转移的预测指标。采用Kaplan-Meier法和Cox模型分析潜在的预后因素。共纳入317例患者进行分析。88例患者存在隐匿性转移，患病率为27.8%。89例患者出现LLN，其中43例患者发生LLN转移。在43例LLN阳性的患者中，20例患者存在隐匿性转移，在274例LLN阴性或无LLN的患者中，68例患者存在隐匿性转移，差异有统计学意义（=0.012）。进一步的多因素回归分析证实LLN转移在预测隐匿性转移方面具有独立性。在无LLN的患者中，5年LRC率为79%，在LLN阴性的患者中，5年LRC率为78%，在LLN阳性的患者中，5年LRC率为62%，差异有统计学意义（=0.024）。在无LLN的患者中，5年DSS率为84%，在LLN阴性的患者中，5年DSS率为74%，在LLN阳性的患者中，5年DSS率为51%，差异有统计学意义（<0.001），进一步的Cox模型证实LLN转移在影响LRC和DSS方面具有独立性。LLN转移与隐匿性颈部淋巴结转移显著相关，并降低早期舌SCC的LRC和DSS。
