国际口腔医学杂志

国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (5): 532-537.doi: 10.7518/gjkq.2024075

• 口腔黏膜病专栏 • 上一篇    下一篇

133例口腔黏膜下纤维性变癌变的病理及临床生物学行为研究

陈冠君1,2(),符骁1,2,冼海瑜2,苏守达1,2,温琦涛2,邓伟1,2,林诗耿2,王涛1,2()   

  1. 1.海南医学院口腔医学院 海口 571199
    2.海南省人民医院口腔科 海口 570311
  • 收稿日期:2024-03-25 修回日期:2024-05-06 出版日期:2024-09-01 发布日期:2024-09-14
  • 通讯作者: 王涛
  • 作者简介:陈冠君，住院医师，硕士，Email：310633109@qq.com
  • 基金资助:
    国家自然科学基金(81960199);海南省重大科技计划、省重点研发计划项目(ZDYF2021SHFZ114)

Retrospective study on the pathological and clinical biological behavior of 133 cases of oral squamous cell carcinomas originated from oral submucous fibrosis

Guanjun Chen1,2(),Xiao Fu1,2,Haiyu Xian2,Shouda Su1,2,Qitao Wen2,Wei Deng1,2,Shigeng Lin2,Tao Wang1,2()   

  1. 1.School of Stomatology, Hainan Medical University, Haikou 571199, China
    2.Dept. of Stomatology, Hainan General Hospital, Haikou 570311, China
  • Received:2024-03-25 Revised:2024-05-06 Online:2024-09-01 Published:2024-09-14
  • Contact: Tao Wang
  • Supported by:
    National Natural Science Foundation of China(81960199);Hainan Province Science and Technology Special Fund(ZDYF2021SHFZ114)

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摘要：

目的 分析嚼食槟榔鲜果习惯的口腔黏膜下纤维性变（OSF）癌变的临床特点、病理及临床生物学行为。 方法 回顾性分析经手术治疗的247例口腔鳞状细胞癌（OSCC）患者，其中嚼食槟榔鲜果习惯的OSF癌变组133例，非OSF癌变组114例，收集患者临床资料和病理结果，对患者的年龄、性别、病变部位、临床分期、病理分级、淋巴结转移率、肿瘤复发率及5年生存率进行分析；使用SPSS 26.0统计软件进行数据分析，P<0.05记为差异有统计学意义。 结果 OSF癌变组的平均年龄（50.68±11.54）岁低于非OSF癌变组（57.90±12.85）岁，OSF癌变组的男女比例高于非OSF癌变组（6.82∶1 vs 2.16∶1），差异具有统计学意义（P<0.05）。OSF癌变组和非OSF癌变组的OSCC病理分化结果差异具有统计学意义（P<0.05），经比较，OSF癌变组的肿瘤分化较好，非OSF癌变患者肿瘤分化较差。OSF癌变组复发率（19.1%）低于非OSF癌变组（31.5%），OSF癌变组5年生存率（85.5%）高于非OSF癌变组（74.8%），差异具有统计学意义（P<0.05）。是否OSF癌变对OSCC淋巴结转移及临床分期的差异无统计学意义（P>0.05）。 结论 具有嚼食槟榔鲜果习惯的OSF癌变患者以男性为主，肿瘤好发于舌及唇颊部，病理分化程度较高，预后较好。

关键词: 口腔黏膜下纤维性变, 癌变, 病理分级, 淋巴结转移, 预后

Abstract:

Objective　This study aimed to analyze the clinical characteristics as well as the pathological and biological behavior of oral squamous cell carcinoma (OSCC) originated from oral submucous fibrosis (OSF) caused by the habit of chewing fresh betel nut. Methods　A total of 247 patients with OSCC who underwent surgical treatment were retrospectively analyzed, including 133 cases of OSCC with OSF caused by the habit of chewing fresh betel nut (OSCC-OSF group) and 114 cases of OSCC without OSF (OSCC group). Clinical data and pathological results of the patients were collected, and the age, sex, lesion location, clinical stage, pathological grade, lymph node metastasis rate, and recurrence rate of the patients were analyzed. SPSS 26.0 was used for data analysis, and differences at P<0.05 were consi-dered statistically significant. Results　The results of this study indicated that the average age of the OSCC-OSF group [(50.68±11.54) years old] was lower than that of the OSCC group [(57.90±12.85) years old]. In addition, the male-to-female ratio in the OSCC-OSF group was higher than that in the OSCC group (6.82∶1 vs 2.16∶1), and the difference was statistically significant (P<0.05). Although OSF canceration has a significant effect on the pathological differentiation of OSCC (P<0.05), the pathological differentiation of the OSCC-OSF group was remarkable, and the pathological differentiation of the OSCC group was poor. The recurrence rate of the OSCC-OSF group (19.1%) was lower than that of the OSCC group (31.5%). The 5-year survival rate of the OSCC-OSF group (85.5%) was higher than that of the OSCC group (74.8%), and the difference was statistically significant (P<0.05). However, OSF has no significant effect on the lymph node metastasis rate and clinical stages of OSCC (P>0.05). Conclusion　The OSF patients with OSCC who also have the habit of chewing fresh betel nut were mainly male. The tumors often occurred in the tongue, cheeks, and lips, and the degree of tumor differentiation and prognosis was good.

Key words: oral submucous fibrosis, canceration, pathological differentiation, lymphatic metastasis, prognosis

中图分类号: 

  • R739.8

表 1

OSF癌变组和非OSF癌变组的临床病理特征"

变量OSF癌变组非OSF癌变组F/χ2/Z值P值
年龄/岁50.68±11.5457.90±12.851.2470.000
性别/ n（%）12.8690.000
男116（87.2）78（68.4）
女17（12.8）36（31.6）
病理分化程度/ n（%）-2.6470.008
高分化113（85.0）a81（71.1）b
中分化16（12.0）a26（22.8）b
低分化4（3.0）a7（6.1）a
淋巴结转移/ n（%）0.5040.478
是38（28.6）28（24.6）
否95（71.4）86（75.4）
临床分期/ n（%）-0.4440.657
T121（15.8）21（18.4）
T281（60.9）69（60.5）
T326（19.5）15（13.2）
T45（3.8）9（7.9）
预后*/ n（%）4.9930.025
复发25（19.1）35（31.5）
无复发106（80.9）76（68.5）
5年生存率*/ n（%）4.4130.036
死亡19（14.5）28（25.2）
存活112（85.5）83（74.8）

表 2

247例OSCC患者的淋巴结转移情况"

临床分期淋巴结转移χ2值P值
是（n=66）否（n=181）
临床早期合计 （T1+T2）44（23.0）147（77.0）5.8390.016
临床晚期合计 （T3+T4）22（39.3）34（60.7）
临床早期1.6510.199
OSF癌变组27（26.7）74（73.3）
非OSF癌变组17（18.9）73（81.1）
临床晚期0.7550.385
OSF癌变组11（34.4）21（65.6）
非OSF癌变组11（45.8）13（54.2）

表 3

247例OSCC患者肿瘤发生部位"

分组部位χ2值P值
舌颊牙龈口咽腭口底唇
OSF癌变组/ n（%）58（43.6）a31（23.3）a12（9.0）a11（8.3）a2（1.5）a7（5.3）a12（9.0）a26.0620.000
非OSF癌变组/n（%）61（53.5）a10（8.8）b11（9.6）a12（10.5）a12（10.5）b7（6.1）a1（1.0）b
例数合计119412323141413
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