Clinical Research About Cervical Lymph Node Metastases Of Early Tongue Squamous Cell Carcinoma

Objectives:Clinical diagnosed early tongue squamous cell carcinoma patients with acertain percentage of cervical lymph node metastasis. It is reported thepositive lymph nodes detected in the same period of neck dissection was12%-30%, and by using serial sectioning and immunohistochemistrytechniques, the rate may be increased to30%-54%.This is mainly due tothe detection of more and more micrometastases. Cervical lymph nodemetastasis is an important prognostic factor, and it is reported thatpatients with cervical lymph node metastases has a significant declinein5-year survival rate compared with those without metastases. It isstill a major problem in early diagnosing and making decision for necktreatment for surgeons. Regarding on this, by analyzing the clinicalfollow-up data we collected, analyse the regional characteristics ofit’s cervical lymph node metastasis，in the hope of seeking morereasonable therapeutic modality for the future clinical use.Methods:（1）Collected the data of171cases of early tongue squamous cellcarcinoma patients since November2008, and to draw an conclusion on thecharacteristics of its’ cervical lymph node metastasis.（2）The171patients were randomly divided into two different groups:the neck dissection group and the observation group. And the data ofpatients’ gender, age, growth site, T stage, histological grade,neurovascular invasion are collected. Then K-M survival analysis and Cox multivariate analysis are used to evaluate the relationship between thefactors and the neck lymph node metastasis.Results:（1）Of the171cases of patients, with18of85neck dissection groupis pathologically confirmed cervical lymph node positive，and5of theneck negative patients ended up with metastasis during their follow upperiod; And17of the86observation group occurred cervical lymph nodemetastasis during their follow-up.（2）There were totally40cases ended up with lymph node metastasis, ofwhich17cases metastasis to levelⅠ、27to levelⅡ、10to levelⅢ、2tolevelⅣ、1to levelⅤ,the percentage are42.5%、67.5%、22.5%、5.0%、2.5%.（3）Kaplan-Meier analysis showed that pathological grading test、Neurovascular invasion were statistically significant, Cox regressionanalysis showed that pathological grading、Neurovascular invasion andolder than or equal to55years old turn out to have an impact.Conclusions:（1）The metastasis of early tongue squamous cell carcinoma has a certainregularity, level II came first, level I followed, then level III,rarely skip metastases.（2）Cervical lymph node metastasis of early tongue squamous cellcarcinoma had no correlation with gender, site of location,and T stagecompared with pathological grading, neurovascular invasion and greaterthan or equal to55years of age, and of which neurovascular invasion hada even greater impact.