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-  2018 

术前颈部淋巴结临床体检和影像学阴性的口腔鳞状细胞癌术后病理确认淋巴结转移的相关影响因素分析 Risk Factors Analysis of Pathologically Confirmed Cervical Lymph Nodes Metastasis in Oral Squamous Cell Carcinoma Patients with Clinically Negative Cervical Lymph Node

Keywords: 口腔鳞状细胞,颈部淋巴结临床阴性,颈部淋巴结清扫术,颈部淋巴结病理转移,危险因素

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Abstract:

目的:探讨颈部淋巴结临床体检和影像学阴性(cN0)的口腔鳞状细胞癌患者术后病理确认颈部淋巴结转移的相关影响因素,为临床治疗提供参考依据。方法:回顾性分析117例cN0的口腔鳞癌患者的临床资料,均行原发灶扩大切除术联合颈部淋巴结清扫术,术后病理确认颈部淋巴结转移区域和个数,通过单因素和多因素Logistic分析患者颈部淋巴结转移的影响因素。结果:117例患者中病理确认颈部淋巴结转移36例(30.77%),其中Ⅰ、Ⅱ、Ⅲ区转移率分别为27.78%、38.89%和22.22%;单因素分析结果显示,年龄、分化程度、生长方式及病灶直径是影响cN0口腔鳞癌颈部淋巴结术后病理确认转移的重要因素(P<0.05);多因素Logistic回归分析结果显示,分化程度、生长方式及病灶直径是颈部淋巴结转移发生的独立危险因素(P<0.05)。结论:分化程度、生长方式及病灶直径为cN0的口腔鳞癌患者颈部淋巴结术后病理确认转移的独立危险因素,对具备上述因素的cN0患者应给予对应颈部淋巴结清扫;未接受或不规范根治性颈清扫患者,如存在上述危险因素,相应区域术后放疗可能存在必要性

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