| Objective:1,To explore the preoperative evaluation value of tumor invasive depth and the distance between the invasive front of the tumor and the skin measured by ultrasonography for squamous cell carcinoma of the buccal mucosa(BMSCC).2,To explore the relationship between BMSCC and lymph node metastasis.Methods:We collected 31 patients with BMSCC treated by combined radical operation of buccal (and jaw) and neck in the Department of Stomatology, the Second Xiangya Hospital of Central South University from Jun 2009 to Apr 2010.We selected 24 patients willing to do ultrasonography preoperation, and measured tumor invasive depth and the distance between the invasive front of the tumor and the skin. We measured the tumor depth of resction of primary after operation by naked eye, collected lymph nodes according to the regions of cervical part, and recorded the size following 5mm,5-10mm,≥10mm,then sent the specimens to the Department of Pathology. Pattern of invasion described by Anneroth was used to evaluate the malignance grade of buccal cancer and we measured histological depth of the primarily tumor(Pointed fixedly by Ocular-micrometer,reconstructed normal mucosa,measured the distance from the surface of the tumor to the deepest point of invasion).Then compared tumor invasive depth measured by ultrasonography with histological depth and analyzed their correlation.Results:1. Compared tumor invasive depth measured by ultrasonography with invasive depth by naked eye, it was not statistically significant (p> 0.05),meanwhile,we found that there was a correlation between them(r=0.981,p<0.05). Compared tumor invasive depth measured by CT with invasive depth by naked eye, it was not statistically significant (p> 0.05),meanwhile,we found that there was correlation between them(r=0.926,p<0.05).Compared the tumor depth of resction of primary after operation by naked eye with histological invasive depth, it was statistically significant (p<0.001).2. Compared the distance between the invasive front of the tumor and the skin measured by ultrasonography with it by naked eye, it was not statistically significant (p> 0.05),meanwhile,we found that there was correlation between them(r=0.978,p<0.05).3. The rate of neck lymph node metastasis was 60%(18/30). Patients with tumor depth in primary< 6 mm had 16.7%(1/6) nodal metastasis, tumor depth>6 mm had 70.8%(17/24) nodal metastasis, there was statistically significant between them(p<0.05).4. The number of the diameter of cervical lymph nodes(the most diameter)≤5mm,5-10mm and≥10mm were 441,306 and 94 respectively, the lymph nodes metastasis rate of them was 0.7%(3/441),5.9% (18/306) and 22.3% (21/94) respectively. There was statistically significant between them(p<0.001).5. The lymph nodes metastasis rate in the different group of patterns of invasion I,Ⅲ,Ⅲand IV were 0%(0/3),36.4%(4/11),83.3%(10/12),100%(4/4) respectively. There were relationship between different patterns of invasion and cervical lymph nodes metastasis(P<0.05).Conclusion:1.It was useful of ultrasonography in measuring tumor depth and the distance between the invasive front of the tumor and the skin before operation, which is helpful for operation plan.2.It was positive relationship between the buccal tumor invasive depth and cervical lymph node metastasis.To those histological invasive depth≥6mm,as the higher cervical lymph node metastasis.3. The patterns of invasionⅢandⅣhad the higher chances of cervical lymph node metastasis. |
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