頸部淋巴結密度及轉移區域分佈做為口腔鱗狀上皮細胞癌預後因子之研究

根據衛福部的統計，台灣惡性腫瘤發生率中口腔癌排名第六位，在男性惡性腫瘤死亡原因裡高居第五名。然而，因其局部區域復發及容易轉移至淋巴結的特性，口腔癌患者的整體存活率在近三十年來並無顯著的改善。許多臨床病理因素皆與口腔癌的存活率有關；然而，尚有許多因素有待進一步的研究與釐清。許多研究顯示頸部淋巴結轉移，導致頭頸部腫瘤的病患的存活率降低。在其它癌症研究發現，除了傳統的TNM分期系統，參考淋巴結密度可以獲得更有效的預測結果。在這項回溯性研究中，收集了口腔鱗狀上皮細胞癌接受手術共計615名患者，分析淋巴結密度及轉移區域分佈，是否爲一個有效的預後的因子。結果發現在單變量和多變量Cox回歸分析中，淋巴結密度＞0.04的患者存活率有顯著的降低（p＜0.00001）。同時發現淋巴結轉移超過一個區域以上，以及伴隨低頸部區域轉移的患者預後較差（p＜0.00001）。淋巴結密度、轉移區域分佈，可以作爲病患評估預後的因子。因此，除了傳統的TNM分期之外，淋巴結密度、轉移區域分佈可納入分期做爲另一個參數，當作輔助治療的參考依據，達到更好的治療效果。

關鍵字

淋巴結密度；淋巴結轉移區域分佈；口腔鱗狀上皮細胞癌；存活率

並列摘要

According to statistics from the Health Promotion Administration, oral cancer ranks sixth in the incidence of malignant tumors in Taiwan and the fifth highest cause of death from male malignant tumors. However, due to the characteristics of local recurrence and easy metastasis to lymph nodes, the overall survival rate of oral cancer has not improved significantly in the past 30 years. Many clinicopathological factors, are related to the survival rate of oral cancer; however, there are still many factors that need to be further studied and clarified. In addition, many studies have shown that neck lymph node metastasis has reduced the survival rate of patients with head and neck tumors. In other cancer studies, it has been found that in addition to the traditional TNM staging system, reference lymph node density can obtain more effective prediction results. In this retrospective study, a total of 615 patients with oral squamous cell carcinoma who underwent surgery, and analyze whether the lymph nodes density and the lymph nodes level of metastasis distribution is an effective prognostic factor. The results showed that in univariate and multivariate Cox regression analysis, the survival rate of patients with lymph node density ＞ 0.04 was significantly reduced (p ＜ 0.00001). At the same time, it was found that patients with lymph node metastasis in more than one level, and patients with metastasis in the low neck level had a poor prognosis (p ＜ 0.00001). The lymph nodes density and the level distribution of metastases can be used as prognostic factors for patients. Therefore, in addition to the traditional TNM staging, lymph node density and metastatic regional distribution can be included in the staging as another parameter, which can be used as a reference basis for adjuvant therapy to achieve better treatment results.

並列關鍵字

Lymph node density ； Lymph node distribution ； Oral squamous cell carcinoma ； Survival rate

國際替代計量

頸部淋巴結密度及轉移區域分佈做為口腔鱗狀上皮細胞癌預後因子之研究

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