Clinical Study On Related Factors Of Cervical Lymphatic Metastasis In Early Tongue Squamous Cell Carcinoma

Objective:Early stage tongue cancer(T1-2N0M0)is more prone to occult lymphatic metastasis than other oral cancer due to its rich blood supply and lymphatic drainage,It is not easy to be discovered in time,which leads to a higher recurrence rate of the tumor.The survival rate and quality of life were seriously affected.Therefore,how to find out the diagnosis of early tongue cancer and evaluate cervical lymph node metastasis is particularly important in clinical treatment.In this paper,the general regularity of cervical lymph node metastasis of early tongue squamous cell carcinoma was discussed by collecting clinical data for retrospective analysis.At the same time,the related influencing factors of occult cervical lymph node metastasis in early stage of tongue cancer were discussed in order to provide a theoretical basis for clinical treatment of the neck in a more reasonable way.Methods:From January 2008 to July 2018,91 patients with primary early tongue cancer were collected in the Department of Oral and Maxillofacial Surgery,First Hospital of Shanxi Medical University.The correlation between cervical lymph node metastasis of early tongue cancer and age,sex,location of primary tumor,depth of invasion,T-stage and pathological grade,and the distribution of cervical lymph node metastasis were statistically analyzed.Results:1.There were 91 cases of early tongue cancer,24 cases of cervical lymphatic metastasis,the metastasis rate was 26.4%,41 cases had neck dissection at the same time,7 cases of cervical lymphatic metastasis,and 5 cases of cervical lymphatic metastasis during the follow-up period.A total of 12 cases,the metastasis rate was 29.3%.There were 50 cases in the observation group.12 cases had cervical lymph node metastasis during the follow-up period,the metastasis rate was 24%.The total transfer rate was 26.4%.2.Lymph node metastasis was distributed in 14 cases in level I,22 in level II,10 in level III,2 in level IV,and 0 in level V.The metastasis rates were 29.2%,45.8%,20.8%,4.2% and 0,respectively.The metastasis rate of level ? was the highest,followed by level ?,rarely skip metastases.3.In univariate analysis,the depth of tumor invasion,t-stage and pathological grade were significantly correlated with cervical lymph node metastasis,p < 0.05;age,sex,primary growth site and cervical lymph node metastasis were not significantly different.In multivariate analysis,the deeper the depth of invasion,the worse the pathological grade had an effect on cervical lymph node metastasis.Conclusion:1.In the early stage of tongue cancer,if no suspicious lymph nodes were found in T1 and T2 stages,neck dissection could be performed at different stages.2.In the early tongue cancer,most of the lymph nodes were located in the levels I,II,III,especially in level ?,rarely skip metastases.3.Cervical lymph node metastasis of early tongue cancer is not related to age,sex and location of primary tumor,but related to T-stage,depth of invasion and pathological grade.It was suggested that simultaneous neck dissection should be performed in patients with stage T2,deeper depth of invasion or poor differentiation.