口腔癌後発リンパ節転移に対する早期診断

概要

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We examined occult metastasis to cervical lymph nodes in ten cases of early oral and oropharyngeal (uvula origin) cancer. In all ten cases, partial excision alone was performed, without performing prophylactic neck dissection. Ultrasonic echo was carried out once every few month after the initial cancer treatment, and tried to detect occult cervical metastasis early. Metastatic lymph node was defined as showing a minor axis/major axis >0.5, and a minor axis >6mm on ultrasonic echo. The period from primary treatment to detection of metastatic lymph node ranged from 4 to 16 months. The average size of the lymph nodes at diagnosis of metastasis was 16×11mm. Pathological diagnosis of metastatic lymph node was detected by FNA in nine cases and excisional biopsy in one case. Although there was a case in which the observation period was short, seven cases survived and the results were better than the previous reports. It is important to perform ultrasonic echography after the initial treatment for early oral cancer in which prophylactic neck dissection was not performed. These results suggest that early detection of occult metastasis from oral cancer by ultrasonic echo can be expected to improve prognoses in cases of occult metastasis.
耳鼻咽喉科臨床学会の論文
2003-04-01