アブストラクト（29巻4号：神奈川歯学）

神奈川歯学

Japanese

Title　： 舌扁平上皮癌の組織内照射後生検の臨床的意義について
Subtitle　： 原著
Authors　： 佐藤倫一, 志村介三
Authors（kana）　：
Organization　： 神奈川歯科大学口腔外科学教室第II講座
Journal　： 神奈川歯学
Volume　： 29
Number　： 4
Page　： 414-425
Year/Month　： 1995 / 3
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」 近年, 口腔癌の治療成績は手術, 放射線, 化学療法の進歩と, それらの併用療法により向上しつつある. 一方, 最近の再建外科の進歩は形態と機能の障害を一段と回復させることができるようになった. しかし形態変化が咀嚼, 嚥下, 発音などへの直接的影響が大きい舌癌では, 現在もなお放射線療法の果たす役割は大きい. 中でも組織内照射は本領域に最も適した療法といえよう. 本療法は一般に, T1-3, NO, ときにN1までの症例に適応される. このような場合, 原発巣制御の如何は治療成績を左右するが, その判断は頸部リンパ節転移への対応を含めた二次治療法の選択にとって極めて重要である. 一般に, 原発巣制御の判断は触診, 視診などによる主観的判断に頼っているのが現状である. 本研究は舌癌の組織内照射例における原発巣制御のより確かな診断法を得ることを目的として, 照射後に生検を行い, 組織学的所見とを比較検討した.
Practice　： 歯科学
Keywords　： 舌扁平上皮癌, 組織内照射, 生検, 組織効果

English

Title　： Clinical Role in Biopsy after Interstitial Irradiation to Squamous Cell Carcinoma of Tongue.
Subtitle　： Original article
Authors　： Tomoichi SATO, Kaizo Shimura
Authors（kana）　：
Organization　： Second Department of Oral and Maxillofacial Surgery, Kanagawa Dental College
Journal　： Kanagawa Shigaku
Volume　： 29
Number　： 4
Page　： 414-425
Year/Month　： 1995 / 3
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： Abstract : In the present study, the clinical role in biopsy after interstitial irradiation therapy was evaluated in 44 cases of squamous cell carcinoma of tongue on which biopsy was done in the department of Oral and Maxillofacial Surgery of Kanagawa Dental College Hospital from June 1974 to August 1993. 1. Biopsy was performed within 3-21 weeks after interstitial irradiation. The average was 5.9 weeks. 2. The histological effect of irradiation (classification of Ohboshi and Shimozato) showed Grade IIb in 9 cases, Grade III in 3 cases and Grade IV in 32 cases, in the residual cancer cell nests of Grade III cases, Ag-NORs granules were rarely observed. The mean value of Ag-NORs counts per nucleus in the residual tumor cells of Grade IIb cases amounted to 2.04-2.74. These results were effective in a determination of Grade III. 3. More residual tumors were observed in the induration-positive groups (showed induration in local site after interstitial irradiation) compared with those of the induration-negative groups. No tumor was histologically observed in 71.4% of the induration-positive groups. They were accompanied by increased collagen fiber. 4. On the adjacent and covering mucous membranes, epithelial dysplasia was detected in 15 cases, 1 case of which was Grade III and 9 cases were Grade IV. Two cases of them recurred. 5. In the intitial stage of interstitial irradiation, reaction of stoma showed that edema, inflammatory cell infiltration, regeneration and dilation of vessels decreased after 6 weeks. The regeneration of collagen fiber increased within 3-14 weeks after irradiation, followed by decrease of its activity. 6. After interstifial irradiation, of 9 cases of Grade IIb, 2 cases treated with surgery and 2 cases with re-interstitial irradiation were survived. Of 3 cases in Grade III, 1 case recurred and was treated with surgery. All the cases, however, were alive. Of 17 cases in Grade IV under careful observation, 14 cases were still alive. Of 15 cases treated with total neck dissection after interstitial irradiation, 11 cases were survived. Four cases in Grade IV, however, recurred. 7. In the present study, two-year primary lesion control rate was 91.2% and the survival rate for 5 years was 74.0% These results suggested that biopsy after irradiation of tongue cancer plays a clinically significant role in controlling primary cancer, selecting the secondary treatment, and avoiding an unnecessary surgery of tongue.
Practice　： Dentistry
Keywords　：