頭頸部癌における微小リンパ節転移の検討

头颈癌微小淋巴结转移的检查

• 批准号: 13770970
• 负责人: 吉田 和秀
• 金额: $ 0.9万
• 依托单位: 大分医科大学
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Young Scientists (B)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13770970/
• 关键词: 舌癌; 頸部リンパ節転移; 微小転移; pN upgrade; 微少転移; 頸部郭清

舌癌は比較的早期から頸部リンパ節転移を来たし,その制御は予後を大きく左右する。重要な予後因子の一つが潜在転移の存在である。近年,多くの悪性腫瘍において,通常のリンパ節のHE染色による診断では検出困難な微量癌細胞の存在(微小転移)が予後に影響することが報告されている。免疫染色に抗cytokeratin抗体を用い,舌癌T2NO症例におけるリンパ節微小転移について検討した。S.57〜H.11の間に当科で手術治療した舌扁平上皮癌T2NO症例24例について検討した。男性14例,、女性10例で平均58.5歳で,治療は放射線治療30Gy後,舌腫瘍摘出・患側の保存的頸部郭清術を行い,全例pull through法による切除・再建を行った。摘出リンパ節を用い,HE染色とcytokeratin染色による微量癌細胞の検出を比較した。HE染色で,は上・中深頸部に各1例づつ全体の8%の症例で潜在転移を認めた。術前の放射線治療のためか,潜在転移率は他の報告より低く,転移リンパ節数も3個と全リンパ節の1%にすぎなかった。一方,cytokeratin染色による検討では顎下・上・中・下深頸部・鎖骨上リンパ節に微小転移を認め,中でも上深頸部に最も多く約半数の症例で陽性であった。全体では24症例中14症例58%の症例に微量癌細胞を認め,従来の潜在転移率を大きく上回る結果となった。また,性別,年齢,腫瘍径,分化度と微小転移の有無には有意な関係はなく,リンパ節径においてのみ有意な差を認めた。pN upgradeはHE染色では2例のみであったが,微小転移を加えると実に14症例58%と半数を超えていたさらに,微小転移の多くが多発性であり.,pN2bにupgradeしたものが11例46%に認められた。以上より,II期舌癌において微小転移の観点からは,術前にすでに広範囲かつ多発性の頸部転移を来たしていることが示唆された。

In the early stage of tongue cancer, patients with tongue cancer were moved around in the early stage of tongue cancer. Important "post-factor"-"potential shift"-there is a potential shift. In recent years, there has been a lot of sexual disorder, and it is common to detect the presence of a small number of cancer cells (micro-migration) in the presence of a small number of cancer cells. Immunostaining of anti-cytokeratin antibody was used in the case of T2NO's disease of tongue cancer. There were 24 cases of T2NO's disease caused by flat epithelial carcinoma of tongue in the department of surgical treatment of S.57~H.11. The average age of 14 males and 10 females was 58.5 years old. After radiotherapy and treatment of 30Gy, the tongue was removed and the preserved part of Guo Qingyuan was performed, and all cases were resected and reconstructed by pull through method. HE staining, cytokeratin staining, trace cancer cells, and specific staining were performed. There were 1 case of HE staining, 1 case of upper, middle and deep part, and 8% of all cases. In front of radiation therapy, the potential transfer rate is low, and the potential transfer rate is low. There are three full-time radiosurgery devices, one percent of which is low. On one side, cytokeratin staining showed that the upper part of the bone was slightly moved, and the upper part of the middle part was more than half of the cases. Of all the 24 cases, 58% of the 14 cases were diagnosed as microcancers, and the potential migration rate was very high. There is a slight change in the degree of differentiation in terms of gender, sex, age, age, and differentiation. There is a slight change in the degree of differentiation. PN upgrade's HE staining showed that there were 2 cases of hypertrophies, 14 cases of 14 cases, 58% of 14 cases, half of them, multiple cases, 11 cases of 46% cases, 14 cases of 14 cases, 50% of cases, 14 cases of 14 cases, 58% of 14 cases, 50% of 14 cases, 50% of 14 cases, 56% of 14 cases, 50% of 14 cases, 56% of 14 cases. In the II stage of tongue cancer, there is a slight movement, a slight movement, a slight shift, a slight movement, and a

项目成果

吉田 和秀, 他: "舌癌T1,2 NO症例における頸部微小リンパ節転移の検討"口腔・咽頭科. 15(1). 112 (2002)

Kazuhide Yoshida 等人：“T1,2 NO 舌癌病例颈部微小淋巴结转移的检查”口腔和咽学 15(1) (2002)。