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背景与目的:舌鳞癌的某些临床、组织病理学特征与隐匿性颈淋巴结转移密切相关。本研究旨在探讨舌鳞癌隐匿性颈淋巴结转移与原发灶临床和病理的相关性。方法:选择1988～1996年间在我院治疗、有隐匿性颈淋巴结转移的舌鳞癌患者35例;另选择同期无颈淋巴结转移的舌鳞癌患者35例,在显微镜下测量肿瘤浸润深度、评定组织病理学参数。结果:70例cN0舌鳞癌中,大体形态为浸润加溃疡型、浸润型、溃疡型和外生型4组的隐匿性颈淋巴结转移率分别为70.37%、41.67%、40.00%和27.27%;T1、T2和T43组分别为44.00%、43.48%和62.64%;肿瘤浸润深度<4mm、4～7.9mm和≥8mm3组的隐匿性颈淋巴结转移率分别为14.29%、61.54%和88.89%;癌周淋巴细胞反应“+”、“++”和“+++”3组分别为73.68%、58.62%和18.18%;脉管侵犯和无脉管侵犯两组分别为85.71%和46.03%;病理为高、中和低分化3组分别为52.63%、42.31%和66.67%;浸润方式为Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型4组分别为40.9%、50.0%、52.0%和80.0%。单因素分析显示原发肿瘤的大体形态、肿瘤浸润深度、癌周淋巴细胞反应程度和脉管侵犯等参数与舌鳞癌隐匿性颈淋巴结转移的相关性有统计学意义(P<0.05),而T分期、病理分化程度和浸润方式等参数与隐匿性颈淋巴结转移的相关性无统计学意义(P>0.05);Logi
BACKGROUND & OBJECTIVE: Some clinical and histopathological features of TSCC are closely related to occult cervical lymph node metastasis. This study aimed to explore the tongue squamous cell carcinoma of the cervical lymph node metastasis and primary clinical and pathological relevance. Methods: Thirty-five patients with tongue squamous cell carcinoma were treated in our hospital from 1988 to 1996 with occult cervical lymph node metastasis. Thirty-five patients with tongue squamous cell carcinoma without cervical lymph node metastasis were selected in the same period. The depth of tumor invasion was measured under the microscope. Histopathological parameters. Results: In 70 cases of cN0 tongue squamous cell carcinoma, the general morphology was infiltration and ulceration. The invasive cervical lymph node metastasis rates in infiltrative, ulcerative and exogenous groups were 70.37%, 41.67%, 40.00% and 27.27%, respectively. The metastatic rate of cervical lymph node metastasis was 14.29%, 61.54% and 88.89% respectively in the groups of 4 ~ 7.9mm and ≥8mm3, the tumor invasion depth was less than 4mm, the tumor invasion rate was 44.00%, 43.48% and 62.64% The rates of “+”, “++” and “+++” in peripheral lymphocytes were 73.68%, 58.62% and 18.18% respectively in the group of lymphocyte reaction and 85.71% and 46.03% in the group of vascular invasion and without vascular invasion respectively. For the high, moderate and poorly differentiated 3 groups were 52.63%, 42.31% and 66.67%, respectively. The infiltration type was 40.9%, 50.0%, 52.0% and 80.0% for type Ⅰ, type Ⅱ, type Ⅲ and type Ⅳ respectively. Univariate analysis showed that there was statistical significance (P <0.05) in the gross morphology of tumor, the depth of tumor invasion, the extent of peri-cancerous lymphocyte reaction and vessel invasion and the occult cervical lymph node metastasis of TSCC T stage, pathological differentiation and infiltration of invasive cervical lymph node metastasis and other parameters and no significant correlation (P> 0.05); Logi