Clinical Study On The Correlation Between The Infiltration Depth Of Gingival Squamous Cell Carcinoma And Lymph Node Metastasis

Obiective :Oral squamous cell carcinoma(OSCC)is the most common cancer in oral and maxillofacial malignancies,and gingival cancer is the second or third in OSCC composition.As squamous cell carcinoma continues to grow,it invades surrounding tissues and metastasizes to the cervical lymph nodes.Although distant metastasis rarely occurs,regional lymph node metastasis is the most important predictor of prognosis in patients with head and neck cancer.There was no evidence of cervical lymphatic metastasis before surgery,and there was no dispute during the same period of neck dissection.When the cervical lymph nodes were negative(cN0)before surgery,there was a divergence in the neck.The ideal method for measuring lymph node metastasis has not been established before surgery,so it is particularly important to look for predictive factors that can predict lymph node metastasis.Proposed invasion as a factor predictive of lymph node metastasis in the literature,so this selection dip profit depth and other relevant factors to conduct a retrospective study,analyzing the correlation of these factors with lymph node metastasis,infiltration clear whether the depth as Predictors of lymph node metastasis.Methods : Thirty patients with pathologically diagnosed maxillary or mandibular gingival squamous cell carcinoma were enrolled in the study.The clinical factors(age,gender,T classification)and pathological factors(invasion depth,degree of differentiation,invasion mode,peritumoral lymphocyte density,vascular invasion)of gingival squamous cell carcinoma were reviewed.The pathological section should conform to the normal tissue basement membrane under the microscope.On this basis,the basement membrane is used as the reference line,and the vertical distance between the two parallel lines measured by the tangent line placed parallel to the basement membrane line on the deepest side of the tumor infiltration area is recorded as infiltration.depth.At the same time,other pathological factors associated with lymph node metastasis were observed under a microscope.Using SPSS20.0 Analyze and process the data obtained in this study.Results: Of the 30 patients,14(46.7%)had a pathological node-negative(pN0)status,and 16 patients(53.3%)had a pathological lymph node-positive(pN +)status.The mean depth of invasion in the node-negative group was 2.19 mm,which was significantly different from the mean value of 4.72 mm observed in the lymph node-positive group.Gingival squamous cell carcinoma has a depth of infiltration from 1 mm to 1.9 mm or less,and patients with no positive lymph nodes.At an invasion depth of 2 mm to 2.9 mm,1(9%)of 11 patients had at least 1 positive lymph node.At 3 mm to 3.9 mm,5 of 5 patients(83.33%)had at least 1 positive lymph node.When the infiltration depth was >4 mm,more than one lymph node metastasis occurred in all 10 patients.The data was statistically analyzed by the ROC curve.The area under the curve(AUC)was 0.978,and the 95% confidence interval CI: 0.931-1,and a meaningful cutoff value was determined at the penetration depth value of 3.16 mm.Univariate logistic regression analysis of factors related to cervical lymph node metastasis of gingival squamous cell carcinoma showed that the depth of invasion and tumor invasion were correlated with lymph node metastasis(P<0.05),while gender,age,pathological grade,T stage,and peritumoral lymphocytic infiltration.There was no significant correlation between density and lymph node metastasis of gingival squamous cell carcinoma.Multivariate logistic regression analysis,only the infiltration depth P = 0.026,OR = 15.223,demonstrating that the depth of invasion is an independent predictor of cervical lymph node metastasis.Conclusion: 1.The regional lymph node metastasis of gingival squamous cell carcinoma has obvious correlation with depth of invasion and invasion mode,but has no significant correlation with age,gender,T classification,differentiation degree,peritumoral lymphocyte density and vascular invasion.2.Invasion depth is the most important predictor of regional lymph node metastasis of gingival squamous cell carcinoma.It is important for the assessment of regional lymph node metastasis.In this study,the depth of invasion can be used as an independent predictor of lymph node metastasis.3.Gingival squamous cell carcinoma infiltration depth greater than or equal to 3.16 mm patients have an increased risk of lymph node metastasis.