[Clinical study of 28 cases of cervical lymph node metastasis from an unknown primary carcinoma].
[Clinical study of 28 cases of cervical lymph node metastasis from an unknown primary carcinoma].
复制标题
原发灶不明的颈淋巴结转移28例临床研究
DOI：
10.3950/jibiinkoka.110.506
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
M. Fujii
中科院分区：
文献类型：
--
作者：
Takamasa Tagawa;T. Tomita;H. Yamaguchi;Hiroyuki Ozawa;K. Sakamoto;K. Ogawa;M. Fujii
从1989年到2005年，我们对28例颈淋巴转移患者进行了回顾性研究，其中男性20例，女性8例。组织学诊断：开放活检11例，非开放活检(术中FNA或冰冻切片诊断)17例。全麻下盲法活检10例，发现鼻咽部原发肿瘤1例。未进行扁桃体切除诊断。在最大淋巴结转移区中，上颈部占22例(79%)。颈淋巴结N分期：N2a期4例，N2b期14例，N2c期3例，N3期7例。病理诊断：鳞状细胞癌21例，腺癌3例，粘液表皮样癌2例，其他2例。治疗方法：单纯颈清扫术7例，颈淋巴清扫术加术后放疗13例，放化疗8例。7名患者被发现有随后的原发肿瘤。原发肿瘤部位：扁桃体3例，上牙龈、舌根、肺、鼻咽各1例。7例患者行FDG-PET检查，但未发现原发肿瘤。在这项研究中，总的5年生存率为46%。对于不明原发癌颈部转移的患者，应特别注意扁桃体的原发肿瘤。
From 1989 to 2005, 28 patients--20 men and 8 women--with cervical lymph node metastasis from an unknown primary carcinoma were treated and studied retrospectively. In histological diagnosis, open biopsy was conducted in 11 patients and non-open biopsy (FNA or frozen section diagnosis during surgery) in 17. Blind biopsy under general anesthesia was conducted in 10 patients, showing one primary tumor in the nasopharynx. Tonsillectomy for diagnosis was not done. In region of maximum-size lymph node metastasis, the upper cervical region accounted for 22 cases (79%). The N stage of cervical lymph nodes was as follows: N2a in 4, N2b in 14, N2c in 3, and N3 in 7. The histopathological diagnosis of cervical lymph node was as follows: squamous cell carcinoma in 21, adenocarcinoma in 3, mucoepidermoid carcinoma in 2, and others in 2. Therapy was as follows: only neck dissection in 7, neck dissection with postoperative radiation therapy in 13, and irradiation and chemotherapy in 8. All patients treated with irradiation and chemotherapy had been judged to be inoperable. Seven patients were found to have a subsequent primary tumor. Primary tumor sites were as follows: tonsils in 3 and upper gingiva, base of tongue, lung, and nasopharynx in 1 each. FDG-PET was conducted in 7 patients but revealed no primary tumor. Overall 5-year survival in this study was 46%. We should pay particular attention to the tonsils for detecting primary tumors in patients with cervical metastasis from an unknown primary carcinoma.