高度浸潤性口腔癌の臨床病態像

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  • Clinical Features of Highly Invasive Oral Cancer.

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A retrospective observation was carried out on the records of 316 tumors with a pathologically proved diagnosis of squamous cell carcinoma of the oral cavity in our clinic from 1976 to 1993. The aim of the study was to clarify clinical features of highly invasive carcinoma, which means mode 4C or 4D by Yamamoto's classification. Eighty cases (26 %) were classified as highly invasive carcinoma ; 49 of these 80 cases (16 %) were mode 4C and 31 cases (10 %) were mode 4D. The incidence of highly invasive carcinoma was low in tumors of upper or lower gingiva when compared with tumors of other locations in the oral cavity. According to the TNM system of UICC set in 1987, the rate of advanced T or N lesion in cases of mode 4C was higher than in cases of the other mode. However, cases of mode 4D among Ti or T2 lesions had the highest rate of N1-3 lesion. On the other hand, clinical stage for highly invasive carcinoma was different accordins to the location of the tumor; there was a tendency that the rate of an advanced stage was higher in tumors of buccal mucosa or gingiva when compared with tumors of the tongue or floor of the mouth. Regarding the growth pattern proposed by Washizu in highly invasive carcinoma, exophytic type was only seen in twelve cases, which belonged to T1 or T2 except for one case.<BR>These observations suggested that clinical behavior of highly invasive carcinoma might be not only different in mode of invasion (4C VS 4D), but also in location or growth pattern of the tumor.

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