口腔扁平上皮癌における予後因子に関する臨床病理組織学的研究

抄録

The uncontrolled or recurrent primary lesion, and the presence of metastatic regional lymph nodes directly affect the prognosis of the cancer patients. The control of primary lesion and regional lymph node metastasis, thus, is utmost importance in achieving a high survival rate in oral squamous cell carcinoma (O-SCC) patients. Therfore, there have been several reports regarding the usefulness of clinical and pathologic parameters relating to prognosis in O-SCC patients. However, these factors predictive of prognosis have not been well described. This study is aimed to investigate the several clinical and pathological parameters in predicting prognosis in patients with O-SCC. The univariate analysis showed that the 5-year survival rates were significantly different between each strata of the prognostic factors including age, tumor size, lymph node metastasis, mitotic figures, inflammatory infiltration, necrotic tendency and vascular atach. Sex, primary site, differentiation, mode of invasion and cellular atypia did not change the survival rates significantly. In pathologic parameters, multivariate analysis using Cox proportional hazard model determined inflammatory cell infiltration, tumor invasive tendency, necrotic tendency, mitotic count and vascular attach as the significant and independent prognostic factors affecting O-SCC. The pathologic parameters including mode of invasion, cellular atypia, mitotic count, necrotic tendency and invasive tendency were correlated with the occurrence of regional lymph node metastasis. These statistical estimated prognostic factors are clinically acceptable and usefull in O-SCC.