【摘要】 目的　探讨口腔颌面部恶性肿瘤颈淋巴转移的特征和规律 ,为临床颈淋巴清扫术提供依据。方法　对 65例颈淋巴清扫术标本进行病理检查 ,并与原发灶特征及淋巴结扪诊状况综合分析。结果　口腔颌面部恶性肿瘤颈淋巴转移率为 46.2 % ,其中N0～N1a病例转移率为 3 6.4% ,N1b～N2b转移率为 66.7% ;上颌牙龈癌、口咽癌、舌癌、颌骨中央性癌及口底癌颈淋巴转移率较高 ,而 8例下颌牙龈癌无一例转移 ;原发灶肿瘤分化程度越低 ,转移率越高 ;另外 ,对颈清扫标本进行连续切片发现 ,7例肿大淋巴结无转移 ,但标本中可见微转移灶。结论　口腔颌面部恶性肿瘤颈淋巴转移与原发灶部位、分化程度及颈淋巴结扪诊断状况有关 ;对颈清扫物有必要行连续切片检查。更多还原

【Abstract】 ? Objective To investigate the patterns of cervical lymphnode metastasis from malignant tumor of oral and maxillofacial regions,and the relationship between the clinicopathological feature of primary lesion and metastasis.Methods Routine lymphnode sections and serial sections were performed on neck dissection specimens obtained from 65 patients with oral cancer、oropharyngeal cancer and central cancer of jaws.Results The total rate of cervical lymphnode metastasis was 46.2% (30/65),the rate of occult metastasis without palpable lymphnode was 46.2%(10/26),that with palpable soft lymphnodes was 33.3%(14/21),and that with palpable hard、immovable lymphnodes was 66.7(14/21).The rate of cervical lymphnode metastasis from oropharyngeal cancer、cancer of upper gingiva、toungue cancer、cancer of floor of mouth and central carcinoma of jaws was higher than that from other oral and maxillofacial region respectively.The cervical lymphnode metastasis rate of tumor with well differentiation was 27.0%(10/37),that with medium and low differentiation was 71.4%(20/21).Metastases were microscopically found in macroscopically swelling lymph node in serial section from radical neck dissection in 7 out of 30 cases.Conclusions Cervical metastasis is closely related to the location、pathological differentiation of the primary lesion,and especially to the status of lymphnode.Serial section is necessary for every specimen to accurately detect the occult lymphnode metastasis. 〔更多还原