Influence On Factors Related To Cervical Lymph Node Metastasis Of Early Tongue Squamous Cell Carcinoma

Objective Oral cancer is one of the most common malignant tumors in the body,and the tongue squamous cell carcinoma is the most common in oral cancer.Cervical lymph node metastasis is an important factor affecting the prognosis of early tongue cancer patients,and its 5-year survival rate is generally about 50%-60%.The early tongue cancer is mostly occult metastasis.Therefore,how to accurately assess the cervical lymph node metastasis in clinical treatment is very important.In this paper,retrospective analysis of clinical data to explore the regularity of cervical lymph node metastasis in early tongue squamous cell carcinoma and to explore the relationship between age,gender,location of primary tumor,T stage,depth of invasion,pathological grade and cervical lymph node metastasis in early tongue cancer,and discuss the impact of occult metastasis on cervical lymph node metastasis.Methods The clinical data of 82 cases of primary early tongue squamous cell carcinoma patients admitted from February 2013 to October 2017 in Department of The Second Hospital of Dalian Medical University Oral and Maxillofacial Surgery were retrospectively analyzed.Among them,simple primary resection of primary tumor was performed in 20 cases and neck dissection was performed in 62 cases.All patients were followed regularly after surgery.The clinical data were statistically analyzed according to age,gender,location of primary tumor,T stage,depth of invasion,pathological grade and distribution of positive cervical lymph nodes metastasis,and to explore the regularity of cervical lymph node metastasis in early tongue squamous cell carcinoma and to make statistical analysis.Results 1.Of the 82 cases of patients,62 cases of neck lymph node dissection were performed.After the pathological examination,24 cases of cervical lymph node metastasis were found and the rate of metastasis was 38.7%.2.In this study,the positive cervical lymph node metastasis of early tongue squamous cell carcinoma were mainly concentrated at levelⅠ,Ⅱ,Ⅲ,while rarely involved at level Ⅳ,Ⅴ,the rate of metastasis for each level was: 22.9%,45.8%,25.5%,4.2%,2.1%.3.In this study,49 patients with c N0 tongue cancer developed cervical lymph node metastasis was 14 cases.The metastasis rate was 28.6%,of which the metastasis rate was highest at level Ⅱ,accounting for 48.3% of all metastases,followed by level Ⅰ and Ⅲ,respectively,24.1% and 20.7%,level Ⅰ,Ⅱ,Ⅲ were accounted for 93.1%.4.Through the univariate analysis of the study,location of primary tumor,T stage,depth of invasion and pathological grade were significantly correlated with cervical lymph node metastasis(P <0.05),while gender and age were not significantly difference with cervical lymph node metastasis(P> 0.05);In the multivariate analysis,only the location of primary tumor,T stage,depth of invasion and pathological grade were correlated with cervical lymph node metastasis in early tongue squamous cell carcinoma(P <0.05),and the depth of invasion was the primary influencing factor for cervical lymph node metastasis.5. Of the 20 patients with simple primary tumor,4 cases had cervical lymph node metastasis and the recurrence rate was 20% at the follow-up period.Of the 62 cases who had cervical lymph node dissection in the same period,5 cases had cervical lymph node metastasis during the follow-up period and the recurrence rate was 8%.Conclusions 1.The cervical lymph node metastasis of early tongue squamous cell carcinoma has some certain regularities,the positive cervical lymph nodes were mainly concentrated at level Ⅰ,Ⅱ,Ⅲ,level Ⅱ came first,followed by level Ⅲ and level Ⅰ,while rarely involved at level Ⅳ,Ⅴ,tately skip metastases.2.The relationship between cervical lymph node metastasis of early tongue squamous cell carcinoma and location of primary tumor,T stage,depth of invasion,pathological differentiation had a correlation.Cervical lymph node metastasis was not significantly correlated with age and gender.3.Occult metastasis was the main factor affecting the recurrence of tongue squamous cell carcinoma in early stage,and the depth of invasion was related to occult metastasis.