Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity
Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity
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DOI：
10.1245/s10434-009-0755-3
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发表时间：
2010-02-01
影响因子：
3.7
通讯作者：
Stoeckli, Sandro J.
中科院分区：
文献类型：
--
作者：
Goerkem, Mete;Braun, Julia;Stoeckli, Sandro J.
背景前哨淋巴结活检（SNB）的cN 0早期鳞状细胞癌（SCC）的口腔已被许多研究证实。大约30%的SNB将检测到隐匿性疾病。原发肿瘤的一些临床和形态学特征被认为是择期颈淋巴结清扫术中隐匿性转移的预测指标。本研究的目的是评估这些因素的背景下，SNB. Methods。前瞻性纳入了2000年至2007年接受SNB治疗T（1/2）口腔SCC的78例患者。对原发性肿瘤的以下形态学和临床参数进行了回顾：分化程度、肿瘤深度、肿瘤厚度、神经周围浸润、淋巴浸润、血管浸润、肌肉浸润、淋巴浆细胞浸润和浸润方式、年龄、性别、原发肿瘤部位、肿瘤侧面和cT分类。统计学分析显示，分化程度（P = 0.002）、淋巴管浸润（P < 0.001）和浸润方式（P <0.001）对SNB隐匿性转移有显著预测意义。其他因素均未达到显著性。平均肿瘤深度为6.45 mm（范围0.72-15.15 mm），平均肿瘤厚度为7.2 mm（范围0.72-15.15 mm）。所有临界值均未达到预测隐匿性疾病的显著性。在SNB的背景下，肿瘤深度和肿瘤厚度未能达到预测隐匿性转移的统计学显著性。cN 0早期口腔鳞状细胞癌患者应提供SNB，无论其肿瘤深度和厚度如何。低分化癌、伴淋巴管炎的癌和浸润方式为溶解性的癌显示SNB阳性的可能性很高。
Background. Sentinel node biopsy (SNB) for cN0 early squamous cell carcinoma (SCC) of the oral cavity has been validated by numerous studies. Around 30% of SNB will detect occult disease. Several clinical and morphological features of the primary tumor have been claimed to be predictive for occult metastasis in elective neck dissections. The aim of this study was to assess these factors in the context of SNB.Methods. Seventy-eight patients undergoing SNB for T(1/2) oral SCC from the years 2000 to 2007 were prospectively included. Primary tumors were reviewed for the following morphological and clinical parameters: grade of differentiation, tumor depth, tumor thickness, perineural invasion, lymphatic invasion, vascular invasion, muscle invasion, lymphoplasmacytic infiltration, and mode of invasion, age, gender, primary tumor site, tumor side, and cT category.Results. Statistical analysis revealed significance to predict occult metastasis in the SNB for grade of differentiation (P = 0.002), lymphatic invasion (P < 0.001), and mode of invasion (P < 0.001). None of the other factors reached significance. The mean tumor depth was 6.45 mm (range 0.72-15.15 mm) and the mean tumor thickness was 7.2 mm (range 0.72-15.15 mm). None of the cutoff values reached significance for predicting occult disease.Conclusions. Tumor depth and tumor thickness failed to achieve statistical significance for prediction of occult metastases in the context of SNB. Patients with cN0 early squamous cell carcinoma of the oral cavity should be offered SNB regardless of their tumor depth and thickness. Poorly differentiated carcinomas, carcinomas with lymphangiosis, and carcinomas with a dissolute mode of invasion show a high probability of positive SNB.