【摘要】 目的分析临床颈部阴性(cN0)舌鳞癌患者的颈部Ⅲ区、Ⅳ区淋巴结微小转移情况。方法采用角蛋白免疫组化染色结合半连续切片技术,对25例cN0舌鳞癌颈部Ⅲ区、Ⅳ区的471个淋巴结进行复查。结果常规病理检查证实有转移的11个位于Ⅲ区的阳性淋巴结,角蛋白免疫组化染色均能检出;在常规病理检查为阴性的460个淋巴结中,角蛋白免疫组化染色结合半连续切片技术,仅在1个Ⅲ区淋巴结中检出一个2．0mm×1．5 mm的微转移灶, 在Ⅳ区淋巴结中未检出微转移灶。结论 cN0舌鳞癌Ⅳ区淋巴结转移率很低,对所有的cN0舌鳞癌患者均清扫Ⅳ区似无必要。更多还原

【Abstract】 Objective To investigate the frequency of micrometastasis in levels Ⅲ-Ⅳ of clinical negative neck (cN0) in patients with squamous cell carcinoma (SCC) of oral longue, and to discuss the management of cervical lymph node for cN0 longue SCC. Methods A total of 471 cervical lymph nodes derived from 25 patients with cN0 longue SCC, including 263 lymph nodes in level Ⅲ and 208 lymph nodes in level Ⅳ, were included in this study. All lymph nodes were re-examined by anti-cytokeratin (CK) immunohistochemical staining combined with semi-serial section per 500 μm. Results Among the 25 cases, seven patients were confirmed harboring metastasis in 11 lymph nodes of level Ⅲ, and no positive lymph node in level Ⅳ was detected by routine hematoxylin-eosin (HE) staining. 11 positive lymph nodes in level Ⅲ, which confirmed by HE staining, were also detected by immunohistochemical staining with CK combined with semiserial section. Among the 460 cervical lymph nodes in which HE staining did not show metastasis, only one lymph node in level Ⅲharboring a 2.0 mm×1.5 mm micrometastasis was detected by immunohistochemical staining with CK, and no positive lymph node in level Ⅳwas delected by immunohistochemical staining with CK. Conclusion The frequency of occult metastasis in level Ⅳwas very low, so it seemed unnecessary to dissect level Ⅳ for all patienls with cN0 longue SCC.更多还原