以選擇性頸部廓清術治療頭頸部類上皮癌之初步評估

Preliminary Evaluation of Elective Neck Dissection for Epidermoid Cancer of the Head and Neck

蔡銘修(Ming-Hsiu Tsai) ； 陳慧炯(Huei-Jung Chen) ； 黃俊生(Tsun-Sheng Huang)

《中華民國耳鼻喉科醫學會雜誌》 30卷2期 (1995/04) Pp. 116-123

https://doi.org/10.6286/1995.30.2.116

摘要

回溯性收集9年間197名接受原發腫瘤部位切除之口腔部、口咽部及喉部類上皮癌病患，統計分析其頸部淋巴結轉移情形。依病患所接受之頸部處置而分為三組：第一組接受治療性頸部淋巴廓清術；第二組接受選擇性頸部淋巴廓清術；三組的頸部不做任何手術處置。由第二組來評估，其偽陰性率達31%。總合來看，其陽性預估值由T1至T4為33.33%，75%，79.17%，70%，其陰性預估值為62.50%，83.33%，66.66%，28.57%，顯示隨T-stage昇高，術前診斷有頸部轉移的正確性就越高，診斷無轉移的正確性就愈低。至於其綜合診斷正確性，則由T1至T4逐漸降低，分別為54.54%，80.55%，73.82%，52.92%。再由評估第二與第三組之頸部復發率，發現對術前診斷為N0的病患，是否施行選擇性頸部淋巴廓清術並不影響其預後，不過由於樣本數量過低以致干擾統計之正確性，此一結果不能做為一肯定結論。

關鍵字

選擇性頸部廓清手術

並列摘要

One hundred and ninety seven patients of epidermoid carcinoma of the oral cavity, orpharynx and larynx who received resection of primary tumor were retrospectively collected to analyze the condition of neck metastasis within 9-year interval. They were categorized into 3 groups as the choice of therapy to their neck: Group I, who received therapeutic neck dissection; Group II, who received elective neck dissection; Group III, no treatment at all, only wait and see. According to group II, the false negative rate was 31%. The positive predictive values, from T1 to T4, were 33.33%, 75%, 79.17%, 70%, respectively. The negative predictive values were 62.50%, 83.33%, 66.66%, 28.57%. It is evident that T-stage could influence clinical diagnosis of neck metastasis. Moreover, the values of diagnostic accuracy, 54.54%, 80.55%, 73.82%, 52.92%, were also in a descending order. Through evaluation of the cervical recurrence rate of group II and III, it seems that elective neck dissection does not affect the prognosis. However, this is not a definite conclusion due to statistical error from the limited numbers of the sample.

並列關鍵字

elective neck dissection