Calabrese Luca, Bizzoca Maria Eleonora, Grigolato Roberto, Maffini Fausto Antonio, Tagliabue Marta, Negro Rosa, Leuci Stefania, Mignogna Michele Davide, Lo Muzio Lorenzo
Division of Otorhinolaryngology, San Maurizio Hospital, 39100 Bolzano, Italy.
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
Life (Basel). 2020 Sep 12;10(9):197. doi: 10.3390/life10090197.
Tongue squamous cell carcinoma is the most common malignancy in the oral cavity. Despite advances in diagnosis and treatment, the prognosis of advanced states has not significantly improved. Depth of invasion, pattern of invasion such as tumor budding grade, lingual lymph node metastasis in early stages, collective cell migration and circulating tumor cells in peripheral blood are some examples of the mechanisms that are currently receiving increasing attention in the evaluation of the prognosis of tongue cancers. Anatomic-based surgery showed that it is possible to improve loco-regional control of tongue cancer. In patients with a "T-N tract involvement", there is significantly more distant recurrence (40%) in patients undergoing a compartmental tongue surgery. In general, the neoplastic infiltration of the lingual muscles is traced back to the finding of neoplastic tissue along the course of a muscle; however, the muscle fibers, due to their spatial conformation and the organization of the extracellular matrix, could influence the movement of tumor cells through the muscle, leaving its three-dimensional structure unchanged. We need to exclude the possibility that tongue muscle fibers represent a mechanism for the diffusion of cancer cells without muscle invasion.
舌鳞状细胞癌是口腔中最常见的恶性肿瘤。尽管在诊断和治疗方面取得了进展，但晚期患者的预后并未得到显著改善。侵袭深度、侵袭模式（如肿瘤芽生分级）、早期舌淋巴结转移、集体细胞迁移以及外周血中的循环肿瘤细胞等，都是目前在舌癌预后评估中越来越受到关注的机制实例。基于解剖的手术表明，改善舌癌的局部区域控制是有可能的。在“T-N 区域受累”的患者中，接受分区舌手术的患者远处复发率显著更高（40%）。一般来说，舌肌的肿瘤浸润可追溯到沿肌肉行程发现肿瘤组织；然而，肌纤维由于其空间构象和细胞外基质的组织，可能会影响肿瘤细胞在肌肉中的移动，而其三维结构保持不变。我们需要排除舌肌纤维代表癌细胞在无肌肉侵袭情况下扩散机制的可能性。
