早期舌扁平上皮癌における頸部リンパ節後発転移・局所再発に関連する因子の臨床病理学的検討

舌扁平上皮癌

北海道歯学会

北海道歯学雑誌

Oral carcinoma in the early stages is now curable ; however, cases with local recurrence and subsequent metastasis have poor prognoses. I conducted experiments to identify the factors concerning recurrence and metastasis. Eighty-one cases of T1 and T2 tongue squamous cell carcinoma were investigated. Clinical examination showed local recurrences were found in 10 cases and secondary metastasis was observed in 20 cases. The invasion pattern of carcinoma was useful to predict secondary metastasis, and the degree of cellular atypia in epithelium adjacent to the carcinoma also had significant correlation with local recurrences. In addition to histological findings, the podoplanin expression ratio in cancer cells had a close relationship with metastasis. Podoplanin highly expressed cases of carcinoma tended to metastasize even in an expansive growth pattern of carcinoma. Podoplanin expression ratio and expression patterns in cancer adjacent epithelium also showed a correlation with local recurrences that were significant among histologically low-risk types of epithelium. It has been reported that podoplanin is expressed in cancer stem cells. The results suggest that the risk of recurrence and subsequent metastasis of early oral carcinoma could be predicted by podoplanin expression in combination with conventional histopathological findings.