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目的分析影响临床颈部淋巴结阴性(cN0期)舌癌术后颈淋巴结转移的相关因素。方法应用颏下岛状肌皮瓣修复cN0期舌癌术后缺损36例,术后对舌癌生长方式、T分期、病理分化程度及隐匿性淋巴结转移情况进行回顾分析。结果术后随访12-36个月,7例发生颈部淋巴结转移,5例死亡。术后颈淋巴结转移与隐匿性淋巴结转移(P<0.05)和病理分化程度相关(P<0.01),而与舌癌的生长方式(P>0.05)和T分期不相关(P>0.05)。结论 cN0期舌癌颏下岛状肌皮瓣修复术后颈淋巴结转移与肿瘤病理分化程度及隐匿性淋巴结转移有关。该手术适用于cN0期高、中分化舌癌术后缺损的修复。
Objective To analyze the related factors that influence the cervical lymph node metastasis of tongue cancer after clinical cervical lymph node negative (cN0 stage). Methods The submental island myocutaneous flap was used to repair 36 cases of cN0 tongue cancer postoperative defect. The growth pattern, T stage, pathological differentiation and occult lymph node metastasis were retrospectively analyzed. Results The patients were followed up for 12-36 months, 7 cases had cervical lymph node metastasis and 5 died. The postoperative cervical lymph node metastasis was correlated with occult lymph node metastasis (P <0.05) and pathological differentiation (P <0.01), but not with the growth pattern of tongue cancer (P> 0.05) and T stage (P> 0.05). Conclusion Cervical lymph node metastasis of cN0 tongue cancer submental island myocutaneous flap is associated with tumor differentiation and occult lymph node metastasis. The operation is suitable for cN0 high, moderately differentiated tongue cancer repair of postoperative defects.