口腔へん平上皮癌の臨床病理組織学的検討 高度浸潤性舌癌について

Abstract

The clinicopathological features of highly invasive carcinomas and nonhighly invasive carcinomas were studied for 76 squamous cell carcinomas of the tongue treated in our department from 1983 through 1995. Highly invasive carcinomas were defined as those showing grades 4 C or 4 D modes of invasion according to Yamamoto's classification. The results were as follows:1. Thirty-two cases (42.1%) were classified as highly invasive carcinoma; 17 of them (22.4%) had grade 4 C mode of invasion, and 15 (19.7%) had grade 4 D mode of invasion.2. According to the TNM system, the incidence of T 2 lesions in grade 4 C and 4 D carcinomas and the N positive rate in the grade 4 D carcinomas were higher than those in nonhighly invasive carcinomas.3. Delayed cervical lymph node metastasis was encountered more often in grade 4 D carcinomas than in carcinomas showing the other modes of invasion.4. Grade 4 C and 4 D carcinomas showed a trend toward lower differentiation and higher invasiveness. The rate of vascular invasion was higher in grade 4 D carcinomas than in carcinomas showing other modes of invasion.5. The 5-year cumulative survival rate for all patients was 63.3%. The 5-year cumulative survival rate for patients with carcinomas showing a mode of invasion of grades 1 to 3 was 74.6%, as compared with 46.3% and 53.3%, in patients with the grade 4 C and 4 D carcinomas, respectively.