舌へん平上皮癌Ｎ０症例における頚部後発転移の予測

Abstract

To predict indicators of occult neck metastasis, we evaluated clinico-pathological findings in N O cases of squamous cell carcinoma of the tongue by the quantification theory type II. The number of N O cases without local failure from 1974 through 1995 was 88. Biopsy specimens were evaluated pathologically after treatment of the primary lesion alone. Cervical lymph node metastasis subsequently developed in 18 cases. Data analysis, in which occult neck metastasis was considered a dependent variate and clinico-pathological findings as an independent variate, indicated that the invasion pattern was the most significant predictor of cervical lymph node metastasis. The presence or absence of occult cervical lymph node metastasis was correctly predicted in 76.1% of the cases.On analysis by the Anneroth classification, the contribution of morphologic variables to metastasis diminished in the following order: mode of invasion, number of mitoses, degree of keratinization, stage of invasion, lymph-plasmocytic infiltration, and nuclear polymorphism. On analysis of the total score derived from the correlation coefficients, occult neck metastasis was not found in patients with a score of 9 or less. The higher the total score, the higher was the incidence of cervical metastasis.