【摘要】 目的　通过分析无临床淋巴结转移舌癌患者的隐匿性淋巴结转移在颈部各区的分布 ,显示舌活动部癌的淋巴结转移并指导无临床淋巴结转移的舌癌的选择性颈淋巴清扫的区域。方法回顾分析 2 8例舌活动部癌颈部无临床淋巴结转移而行选择性全颈淋巴结清扫和挽救性颈淋巴结清扫术的病例 ,分析手术后病理阳性淋巴结在颈部各区的分布。结果　病理证实单个淋巴结转移 13例 ,其中颌下及颏下区转移 2例、颈内静脉淋巴结上组 8例、颈内静脉淋巴结中组 3例 ,无颈内静脉淋巴结下组和颈后三角及锁骨上淋巴结隐匿性淋巴结转移。多个淋巴结转移 15例 ,其中以颈内静脉淋巴结中组为第 1站的有 2例。共有 17 9% (5 /2 8)无颈内静脉淋巴结上组转移 ,而单独以颈内静脉淋巴结中组为转移的第 1站。各区转移频率分别为 :颌下及颏下区转移 17 5 % ;颈内静脉淋巴结上组5 2 5 % ;颈内静脉淋巴结中组 2 5 5 % ;颈内静脉淋巴结下组、颈后三角及锁骨上淋巴结各为 2 5 %。结论　颈内静脉淋巴结中组同颈内静脉淋巴结上组一样 ,都为舌活动部癌的第 1站淋巴结。建议对无临床淋巴结转移舌活动部癌的颈部处理应行颌下至颈内静脉淋巴结下组的局限性淋巴结清扫术。更多还原

【Abstract】 Objective To evaluate the validity of selective surgery for the N 0 neck in squamous cell carcinoma of the mobile tongue Methods 116 patients with N 0 neck of the mobile tongue cancer who underwent comprehensive RND and 5 patients who had a selective RND were reviewed retrospectively Results According to the suggestion of division of neck level, 7 patients had metastasis at level I; 21, level II; 10, level III, 1 case for level IV or V each There were 5 cases with level III involvement as a first echelon of metastasis which was peculiar for the neck metastasis of mobile tongue Conclusions For N 0 neck of the mobile tongue cancer, a neck dissection of level I～III or level I～IV is more than enough更多还原