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目的 探讨口腔颌面部恶性肿瘤颈淋巴转移的特征和规律 ,为临床颈淋巴清扫术提供依据。方法 对 65例颈淋巴清扫术标本进行病理检查 ,并与原发灶特征及淋巴结扪诊状况综合分析。结果 口腔颌面部恶性肿瘤颈淋巴转移率为 46.2 % ,其中N0～N1a病例转移率为 3 6.4% ,N1b～N2b转移率为 66.7% ;上颌牙龈癌、口咽癌、舌癌、颌骨中央性癌及口底癌颈淋巴转移率较高 ,而 8例下颌牙龈癌无一例转移 ;原发灶肿瘤分化程度越低 ,转移率越高 ;另外 ,对颈清扫标本进行连续切片发现 ,7例肿大淋巴结无转移 ,但标本中可见微转移灶。结论 口腔颌面部恶性肿瘤颈淋巴转移与原发灶部位、分化程度及颈淋巴结扪诊断状况有关 ;对颈清扫物有必要行连续切片检查。
Objective To investigate the characteristics and regularities of cervical lymph node metastasis in oral and maxillofacial malignancies, and provide basis for clinical cervical lymph node dissection. Methods Sixty-five cases of cervical lymph node dissection were examined by pathological examination and analyzed comprehensively with characteristics of the primary tumor and lymph node status. Results The rate of cervical lymph node metastasis in oral and maxillofacial malignancies was 46.2%. Among them, the metastatic rate of N0-N1a was 36.4%, and the N1b-N2b metastasis rate was 66.7%; maxillary gingiva, oropharyngeal cancer, tongue cancer, and central jaw The rate of cervical lymph node metastasis was higher in cancers of the mouth and floor, while there was no metastasis in 8 cases of gingival cancer of the mandible. The lower the degree of differentiation of the primary tumors, the higher the metastasis rate; in addition, serial sections of cervical sial specimens were found in 7 cases. There was no metastasis in the enlarged lymph nodes, but micrometastases were visible in the specimens. Conclusion The cervical lymph node metastasis of oral and maxillofacial malignancy is related to the location of primary tumors, the degree of differentiation, and the diagnosis of cervical lymph node spasm. Continuous neck biopsy is necessary for neck neoplasms.