同部位舌癌的不同厚度与颈淋巴结转移间的相关性
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摘要
目的探讨同部位舌癌厚度与颈淋巴结转移的关系。方法回顾性分析手术切除的T1、T2期舌癌手术标本98例,测量舌癌厚度,对舌癌进行病理分级和TMN分期;探讨患者颈淋巴结转移与临床病理因素的关系,重点分析舌癌厚度与颈淋巴结转移的关系;检测患者血清血管内皮细胞生长因子(VEGF)水平。结果舌癌组织颈淋巴结转移与病理分级、舌癌厚度相关,而与病程、部位、面积、T分期和N分期无相关。随着舌癌厚度增加,颈淋巴结转移率呈现逐渐升高,在厚度为7~10 mm时,转移率最高;舌癌厚度大于7 mm时,颈淋巴结转移率均明显高于3~5 mm和5~7 mm组,比较差异有统计学意义(P<0.01,P<0.05);舌癌厚度大于10 mm组与7~10 mm组比较,颈淋巴结转移率变化不明显。舌癌厚度≥7 mm组患者血清VEGF含量明显高于<7 mm组(P<0.01)。结论舌癌厚度测量对评估早期舌癌颈淋巴结转移有重要意义,可能与患者VEGF水平升高相关。
Objective To study the correlation between thickness of tongue cancer and cervical lymph node metastasis.Methods 98 cases with T1 and T2 tongue cancer were retrospectively analyzed. Thickness of tongue cancer was measured,and pathological grading and TMN stage were analyzed. The relationship between cervical lymph node metastasis and clinicopathological parameters,especially between thickness of tongue cancer and cervical lymph node metastasis were analyzed. Serum level of vascular endothelial growth factor( VEGF) in all patients was detected. Results Cervical lymph nodes metastasis of tongue cancer was highly correlated with histological grade and thickness of tongue cancer,but not with course of disease,position,area,T stage,and N stage. Metastasis rate was increased following raise of thickness of tongue cancer,and metastasis rate was highest at 7~ 10 mm. When thickness of tongue cancer was bigger than 7 mm,metastasis rate of cervical lymph node was higher than that of3 ~ 5 mm group and 5 ~ 7 mm group,there had statistical difference( P < 0. 01,P < 0. 05). Cervical lymph node metastasis had no statistical difference between > 10 mm group and 7 ~ 10 mm group. Serum level of VEGF in thickness of tongue cancer ≥7 mm group was obviously higher than that < 7 mm group( P < 0. 01). Conclusion Thickness of tongue cancer can play an important role in evaluating cervical lymph node metastasis,which may be related with increase of serum VEGF level.
Objective To study the correlation between thickness of tongue cancer and cervical lymph node metastasis.Methods 98 cases with T1 and T2 tongue cancer were retrospectively analyzed. Thickness of tongue cancer was measured,and pathological grading and TMN stage were analyzed. The relationship between cervical lymph node metastasis and clinicopathological parameters,especially between thickness of tongue cancer and cervical lymph node metastasis were analyzed. Serum level of vascular endothelial growth factor( VEGF) in all patients was detected. Results Cervical lymph nodes metastasis of tongue cancer was highly correlated with histological grade and thickness of tongue cancer,but not with course of disease,position,area,T stage,and N stage. Metastasis rate was increased following raise of thickness of tongue cancer,and metastasis rate was highest at 7~ 10 mm. When thickness of tongue cancer was bigger than 7 mm,metastasis rate of cervical lymph node was higher than that of3 ~ 5 mm group and 5 ~ 7 mm group,there had statistical difference( P < 0. 01,P < 0. 05). Cervical lymph node metastasis had no statistical difference between > 10 mm group and 7 ~ 10 mm group. Serum level of VEGF in thickness of tongue cancer ≥7 mm group was obviously higher than that < 7 mm group( P < 0. 01). Conclusion Thickness of tongue cancer can play an important role in evaluating cervical lymph node metastasis,which may be related with increase of serum VEGF level.
引文
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[11]Shen Z,Kauttu T,Seppnen H,et al.Vasohibin-1 and vasohibin-2 expression in gastric cancer cells and TAMs〔J〕.Med Oncol,2012,9(4):2718-2726.
[12]Huang TH,Chiu YH,Chan YL,et al.Prophylactic administration of fucoidan represses cancer metastasis by inhibiting vascular endothelial growth factor(VEGF)and matrix metalloproteinases(MMPs)in lewis tumor-bearing mice〔J〕.Mar Drugs,2015,13(4):1882-1900.
[13]BilgiCI,Tez M.Serum VEGF levels in gastric cancer patients:correlation with clinicopathological parameters〔J〕.Turk J Med Sci,2015,45(1):112-117.
[14]黄欣,温玉明,李龙江.外周血VEGF表达水平与舌癌颈淋巴结转移关系的临床研究〔J〕.实用口腔医学杂志,2004,20(3):329-331.
[2]Sano K,Kitai R,Yoshimura H,et al.Frontal meningioma incidentally detected in the routine preoperative assessment of tongue cancer:a case report and literature review〔J〕.J Oral Maxillofac Surg,2013,71(12):2195.e1-6.
[3]Zhang T,Ord RA,Wei WI,et al.Sublingual lymph node metastasis of early tongue cancer:report of two cases and review of the literature〔J〕.Int J Oral Maxillofac Surg,2011,40(6):597-600.
[4]International Union Against Cancer.TMN classification of malignant tumours〔M〕.6th ed.New York:Wiley,2002:102.
[5]Pindborg JJ,Reichart PA,Smith CJ,et al.Histological typing of cancer and precancer of the oral mucosa〔M〕.2nd Edition.New York:Springer-Verlag Berlin heideberg,1997:11-12.
[6]Matos LL,Manfro G,Santos RV,et al.Tumor thickness as a predictive factor of lymph node metastasis and disease recurrence in T1N0 and T2N0 squamous cell carcinoma of the oral tongue〔J〕.Oral Surg Oral Med Oral Pathol Oral Radiol,2014,118(2):209-217.
[7]Iwai T,Baba J,ShⅠBasaki M,et al.18F-fluorodeoxyglucose-positive Warthin tumor in a contralateral cervical lymph node mimicking metastasis in tongue cancer staging with PET/CT〔J〕.J Craniofac Surg,2012,23(5):e507-509.
[8]Lloyd S,Yu JB,Wilson LD,et al.The prognostic importance of midline involvement in oral tongue cancer〔J〕.Am J Clin Oncol,2012,35(5):468-473.
[9]Sparano A,Weinstein G,Chalian A,et al.Multivariate predictors of occult neck metastasis in early oral tongue cancer〔J〕.Otolaryngol Head Neck Surg,2004,131(4):472-476.
[10]周辉红,徐秋华,胡永杰,等.舌鳞状细胞癌厚度与区域淋巴结转移的超声研究〔J〕.上海口腔医学,2008,17(5):465-470.
[11]Shen Z,Kauttu T,Seppnen H,et al.Vasohibin-1 and vasohibin-2 expression in gastric cancer cells and TAMs〔J〕.Med Oncol,2012,9(4):2718-2726.
[12]Huang TH,Chiu YH,Chan YL,et al.Prophylactic administration of fucoidan represses cancer metastasis by inhibiting vascular endothelial growth factor(VEGF)and matrix metalloproteinases(MMPs)in lewis tumor-bearing mice〔J〕.Mar Drugs,2015,13(4):1882-1900.
[13]BilgiCI,Tez M.Serum VEGF levels in gastric cancer patients:correlation with clinicopathological parameters〔J〕.Turk J Med Sci,2015,45(1):112-117.
[14]黄欣,温玉明,李龙江.外周血VEGF表达水平与舌癌颈淋巴结转移关系的临床研究〔J〕.实用口腔医学杂志,2004,20(3):329-331.