国际口腔医学杂志 ›› 2021, Vol. 48 ›› Issue (4): 444-449.doi: 10.7518/gjkq.2021077

• 综述 • 上一篇    下一篇

上颌鳞状细胞癌临床颈部淋巴结阴性患者的治疗

李珊(),陈林林()   

  1. 南昌大学附属口腔医院口腔颌面外科 江西省口腔生物医学重点实验室 南昌 330000
  • 收稿日期:2021-01-05 修回日期:2021-04-07 出版日期:2021-07-01 发布日期:2021-06-30
  • 通讯作者: 陈林林
  • 作者简介:李珊,硕士,Email: 11606019129@qq.com

Treatment of patients with negative cervical lymph nodes in maxillary squamous cell carcinoma

Li Shan(),Chen Linlin()   

  1. Dept. of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine in Jiangxi Province, Nanchang 330000, China
  • Received:2021-01-05 Revised:2021-04-07 Online:2021-07-01 Published:2021-06-30
  • Contact: Linlin Chen

摘要:

原发于上颌牙龈和硬腭的上颌鳞状细胞癌(MSCC)是一种相对较少见的头颈部肿瘤,患病率相对较低,病例收集难度较大,因此目前有关MSCC颈部淋巴结阴性患者治疗和预后的研究仍然较少,且其临床治疗策略存在争议,国际上也无统一的治疗指导策略。目前的研究显示:MSCC患者颈部淋巴结的总转移率为21%~46.1%,主要影响因素有肿瘤分期、分化程度、肿瘤位置、神经血管侵犯及骨浸润等;MSCC的5年生存率为32%~70.8%,主要影响因素有颈部淋巴结转移、肿瘤位置、选择性颈部淋巴结清扫等;MSCC存在对侧及双侧转移的风险,颈部复发率可达33%,且挽救性手术成功率低。根据目前的研究成果,推荐T3/T4期临床颈部淋巴结阴性患者行选择性颈部淋巴结清扫,并建议后续设计更多前瞻性、大样本量的研究,增强结果的可靠性,为临床治疗提供参考。

关键词: 上颌牙龈, 硬腭, 鳞状细胞癌, 颈部淋巴结转移, 颈部淋巴结清扫

Abstract:

Maxillary squamous cell carcinoma (MSCC) with primary maxillary gingiva and hard palate is a relatively rare head and neck tumor. Considering the low incidence and the difficulty of case collection, only few studies focused on the clinical cervical lymph node-negative patients of MSCC. The related clinical treatment strategies are controversial, and a unified treatment guidance strategy remains lacking worldwide. The total rate of cervical lymph node metastasis in patients with MSCC is 21%-46.1%. The main influencing factors are tumor stage, degree of differentiation, location, neurovascular invasion, and bone infiltration. The 5-year survival rate of MSCC is 32%-70.8%. The main influencing factors are cervical lymph node metastasis, location, selective cervical lymph node dissection, and so on. MSCC has the risk of contralateral and bilateral metastases, the neck recurrence rate can reach 33%, and the success rate of salvage surgery is low. Selective neck dissection is recommended for patients with negative cervical lymph nodes in the T3/4 stage. A prospective, large-scale study is necessary to enhance the reliability of the results and provide powerful references for clinical treatment.

Key words: maxillary gingiva, hard palate, squamous cell carcinoma, cervical lymph node metastasis, cervical lymph node dissection

中图分类号: 

  • R730.56
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