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背景与目的:对于临床颈淋巴结阴性(cN0)的舌癌颈部的处理一直存在争议,本研究旨在探讨cN0舌体鳞癌颈部的合理治疗方案。方法:回顾性分析187例手术前后未行放、化疗的cN0舌体鳞癌初诊患者的临床资料;分析颈部隐匿性淋巴结转移规律和隐匿性淋巴结转移及预后的影响因素,以及颈部不同处理方式的控制情况。结果:隐匿性淋巴结转移率为23.0%,其最常见的位置在同侧颈Ⅱ区,83.0%的隐匿性淋巴结转移分布在同侧颈Ⅰ、Ⅱ、Ⅲ区;病理分级是影响隐匿性淋巴结转移的独立因素;隐匿性淋巴结转移为影响cN0舌癌患者预后的独立因素;肩胛舌骨肌上清扫术的颈部复发率为6.7%。结论:肩胛舌骨肌上颈清扫术是cN0舌体鳞癌患者有效而安全的治疗措施。
BACKGROUND & OBJECTIVE: There has been controversy over the treatment of tongue neck cancers with clinical cervical lymph node negative (cN0). This study aimed to investigate the rational treatment of cervical squamous cell carcinoma of cN0 tongue squamous cell carcinoma. Methods: The clinical data of 187 patients with newly diagnosed squamous cell carcinoma of cN0 tongue before and after operation were retrospectively analyzed. The influencing factors of latent cervical lymph node metastasis and occult lymph node metastasis and prognosis were analyzed, and the different treatment of neck Way of control. Results: The occult lymph node metastasis rate was 23.0%. The most common site was located in ipsilateral cervical region Ⅱ. 83.0% of occult lymph node metastases were located in ipsilateral neoplasms Ⅰ, Ⅱ, and Ⅲ. The pathological grade of the occult lymphnode metastasis Of the independent factors; occult lymph node metastasis is an independent factor affecting the prognosis of cN0 tongue cancer patients; the recurrence rate of the neck of the scapular hyoid muscle was 6.7%. Conclusion: Scapular hyoid muscle neck dissection is an effective and safe treatment for cN0 tongue squamous cell carcinoma.