早期口腔鳞状细胞癌:有必要行择区性颈清扫吗?
2017/9/13 创新医学网

    

     文章来源:欧尔意 OAE 微信号

     作者:Sofina

    

     原文出处

     Moreno-García C. Elective neck dissection in early oral squamous cell carcinoma: necessary? Plast Aesthet Res 2016;3:167-74.

     DOI:10.20517/2347-9264.2016.12

     摘要

     目的:口腔鳞状细胞癌(OSCC)的颈清扫指征其实质是个风险收益问题,其中包含了颈部转移的概率、颈清扫的并发症以及转移的延迟诊断对于预后的影响。对于临床N0(cN0)的早期口腔癌患者的择区性颈清扫,大家并无一致观点。方法:作者通过关键词“elective neck dissection vs. Observation”, “node negative neck”和“early stage oral squamous cell carcinoma”在PubMed中进行搜索。作者选择了那些对比早期OSCC(T1-T2)患者行择区性颈清扫(END)和临床观察的文章。结果:很多研究都对早期OSCC患者行择区性颈清扫(END)和临床观察的结果进行了对比。早期口腔鳞癌患者的生物学侵袭性反映在了它对区域淋巴链的转移能力上。已经研究了很多用来减少隐匿性转移的影像学技术,通过比较发现超声引导下细针吸取活检(USgFNAC)最为可靠。结论:几个非随机试验证明了在严格以USgFNAC进行随访的患者中,END并不具有优势。因此,如果不能保证有训练有素的超声检查师用USgFNAC来进行严格的常规随访,END还是最安全的策略。

     关键词:早期;口腔鳞状细胞癌;颈淋巴结阴性;择区性颈清扫和观察

     Aim: The indication of neck dissection in oral squamous cell carcinoma (OSCC) is a problem of risk-benefit evaluation between probability of neck metastases, the problem of complications associated with neck dissection and the prognostic influence of delayed diagnosis of metastasis during follow-up. There is no consensus on the elective treatment of the neck in early oral cancer patients with a clinically N0 (cN0) neck. Methods: The author performed a search of PubMed articles with the words "elective neck dissection vs. observation", "node negative neck" and "early stage oral squamous cell carcinoma". The author selected those articles that studied the early OSCC (T1-T2), and elective neck treatment was compared with clinical observation. Results: Many studies have compared the outcome of elective neck dissection (END) to observation of the neck in early OSCC. The results of them are described. The biologic aggressiveness of oral cavity squamous cell carcinoma, particularly in the early stages, is reflected in its ability to metastasize to regional lymph node chains. Many pretreatment imaging techniques to diminish the incidence of occult metastases haven been studied, and comparative studies have shown ultrasound guided fine needle aspiration cytology (USgFNAC) to be the most accurate. Conclusion: A few non-randomized studies have shown no advantages of END when strict USgFNAC follow-up was employed. Thus, if routine strict follow-up using USgFNAC by a well-trained ultrasonographer cannot be assured, END is the safest strategy.

     Keywords: Early stage; oral squamous cell carcinoma; negative lymph necknode; elective neck dissection versus observation

     原文链接

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     本文是“State of the Art in the Management of Oral Squamous Cell Carcinoma”专题里面的一篇,想要了解更多此专题文章,请复制链接http://parjournal.net/journal/section/71到浏览器中阅读。

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     本文摘要由中国医科大学口腔颌面外科头颈外科系刘法昱教授翻译提供,中文内容仅供参考,一切以英文原版为主。

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