Stein A L, Tahan S R
Department of Pathology, New England Deaconess Hospital, Boston, MA 02215.
J Cutan Pathol. 1994 Feb;21(1):16-21. doi: 10.1111/j.1600-0560.1994.tb00685.x.
Clinical and histologic features of 44 invasive squamous cell carcinomas of the lip treated by surgical excision were correlated with metastases and survival. Age, diameter, ulceration, grade, depth of invasion, muscle invasion, mitotic rate, lymphatic-vascular invasion, and tumor infiltrating lymphocytes were evaluated. Two (4.5%) patients had local recurrence, 10 (23%) had metastases to cervical lymph nodes, and 2 (4.5%) died from complications of extensive spread in the neck. One patient with local recurrence had regional node metastases. Regional metastases were discovered at the time of (3 patients) or up to 21 (median 8) months after initial diagnosis, correlating with ulceration (P = 0.003), depth of invasion (P = 0.0001), and mitotic rate (P = 0.05) of the primary tumor. Depth exceeding 2.0 mm. was associated with metastasis (P = 0.028), and all carcinomas deeper than 6.0 mm. metastasized. Eight of the 10 patients with regional metastases had no further disease after treatment through the follow-up period (median 64 months). Both fatalities were older (median 81 years) men. These results underscore the metastatic potential of invasive squamous cell carcinoma of the lip. Histologic analysis of the primary lesion can be used to identify individuals at risk.
对44例经手术切除治疗的唇部浸润性鳞状细胞癌的临床和组织学特征与转移及生存情况进行了相关性分析。评估了年龄、直径、溃疡情况、分级、浸润深度、肌肉浸润情况、有丝分裂率、淋巴管血管浸润情况以及肿瘤浸润淋巴细胞情况。2例（4.5%）患者出现局部复发，10例（23%）出现颈部淋巴结转移，2例（4.5%）死于颈部广泛扩散的并发症。1例局部复发患者有区域淋巴结转移。区域转移在初次诊断时（3例患者）或初次诊断后长达21个月（中位时间8个月）时被发现，与原发肿瘤的溃疡情况（P = 0.003）、浸润深度（P = 0.0001）和有丝分裂率（P = 0.05）相关。浸润深度超过2.0 mm与转移相关（P = 0.028），所有浸润深度超过6.0 mm的癌均发生转移。10例有区域转移的患者中，8例在随访期（中位时间64个月）治疗后无进一步疾病进展。2例死亡患者均为年龄较大（中位年龄81岁）的男性。这些结果强调了唇部浸润性鳞状细胞癌的转移潜能。对原发灶的组织学分析可用于识别有风险的个体。
