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[口腔鳞状细胞癌颈淋巴结转移的临床病理特征及预后因素]

[Clinicopathologic features and prognostic factors of cervical lymph node metastasis in oral squamous cell carcinoma].

作者信息

Li Xiao-Ming, DI Bin, Shang Yao-Dong, Li Jun, Cheng Ji-Min

机构信息

Department of Otolaryngology Head & Neck Surgery/PLA Center for Otolaryngological Diseases, Bethune International Peace Hospital, Shijiazhuang, Hebei, 050082, P. R. China.

出版信息

Ai Zheng. 2005 Feb;24(2):208-12.

Abstract

BACKGROUND & OBJECTIVE: The cervical lymphatic meta-static rate of oral squamous carcinoma is 50%-59%. The management of cervical lymphatic metastasis relates with prognosis of patients with oral squamous carcinoma. This study was to investigate the clinicopathologic features and prognosis factors of cervical lymph node metastasis in oral squamous cell carcinoma.

METHODS

Clinicopathologic data of 191 patients with oral squamous cell carcinoma were retrospectively reviewed. The relationship between histopathologic factors and cervical lymph node metastasis was evaluated by univariate Chi(2) test. Cox regression model was used to analyze impacts of pathologic factors of cervical lymph nodes, such as metastatic status, size and number of positive neck nodes,levels of positive nodes, the lowest involved nodal level, on prognosis.

RESULTS

The overall 5-year survival rate of the 191 patients was 48.7%. Univariate Chi(2) test confirmed that only depth of primary tumor infiltration correlated to cervical lymph node metastasis. Cox regression analysis revealed that clinical N stage, cervical lymphatic metastatic status, number of involved levels, and the lowest involved nodal level affected prognosis of patients, the most significant prognostic factors of cervical lymph node were clinical N stage, and the lowest involved nodal level.

CONCLUSIONS

Cervical lymph node metastasis is a significant prognostic factor of oral squamous cell carcinoma. The identification of metastatic patterns of cervical lymph nodes, and the management targeting pathologic factors of cervical lymph node affecting survival are critical for improving the treatment effect on oral squamous cell carcinoma.

摘要

背景与目的

口腔鳞状细胞癌的颈部淋巴结转移率为50% - 59%。颈部淋巴结转移的处理与口腔鳞状细胞癌患者的预后相关。本研究旨在探讨口腔鳞状细胞癌颈部淋巴结转移的临床病理特征及预后因素。

方法

回顾性分析191例口腔鳞状细胞癌患者的临床病理资料。采用单因素卡方检验评估组织病理学因素与颈部淋巴结转移的关系。应用Cox回归模型分析颈部淋巴结的病理因素,如转移状态、阳性颈部淋巴结的大小和数量、阳性淋巴结的水平、最低受累淋巴结水平对预后的影响。

结果

191例患者的总体5年生存率为48.7%。单因素卡方检验证实,仅原发肿瘤浸润深度与颈部淋巴结转移相关。Cox回归分析显示,临床N分期、颈部淋巴结转移状态、受累水平数量及最低受累淋巴结水平影响患者预后,颈部淋巴结最重要的预后因素为临床N分期和最低受累淋巴结水平。

结论

颈部淋巴结转移是口腔鳞状细胞癌的重要预后因素。明确颈部淋巴结转移模式,并针对影响生存的颈部淋巴结病理因素进行处理,对提高口腔鳞状细胞癌的治疗效果至关重要。

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