@article{oai:sapmed.repo.nii.ac.jp:00014780,
 author = {宮川, 明 and 平塚, 博義 and 小浜, 源郁},
 issue = {1},
 journal = {札幌医学雑誌 = The Sapporo medical journal, The Sapporo medical journal},
 month = {Feb},
 note = {A retrospective analysis of one hundred and forty-one surgical cases of previously untreated squamous cell carcinoma of the oral cavity with no clinically positive nodes （N-O） was performed in order to elucidate the clinical and histopathological factors predicting occult nodal metastasis. Ninety-six of 141 patients were treated by peroral excision ; 80 of these had N-O during follow up ; the other 16 had delayed neck dissection when nodes became clinically involved. Forty-five of 141 patients were treated by excision of primary lesion combined with elective neck dissection. The frequencies of nodal involvement were 15.6% （15/96） in the former and 24.4% （ll/45） in the letter. The overall incidence of occult nodal metastasis was 18.4% （26/141）. Patients with occult nodal metastasis had significantly lower 5-year cumulative survival rates than those with uninvolved nodes （44.1% vs 93.7%, p<0.001）. The malignancy grading was based upon three different morphologic characteristics for the tumor cell population （type of differentiation, cellular atypism, mitotic index） and two characteristics for the tumor-host relationship （mononuclear inflammatory infiltrates, mode of cancer invasion）. Patients with malignancy score≧10 had high risk of occult nodal metastasis regardless of tumor size ; those of score ≧14 showed particularly high risk of microscopic positive nodes. Quantification Theory Type II analysis was performed in an attempt to elucidate the relationship between, clinical and histopathological findings and occult nodal metastasis. The clinical （age, site, tumor size, growth pattern） and histopathological （type of differentiation, cellular atypism, degree of mitotic index, mode of cancer invasion） findings and the occurrence of nodal metastasis were related on the basis of the partial correlation coefficients. The contributions to occult nodal metastasis of each of the clinical and histopathological factors were, in descending order, mode of cancer invasion, site, tumor size, and type of differentiation of cancer cells. The discrimination ratio between microscopic positive and negative cervical lymph nodes was 90.1%. The histological malignancy score closely correlated with nodal status and appears to be a valid indicator for prediction of occult nodal metastasis. This criterion may serve in establishing the therapeutic course for cervical lymph nodes in occult metastasis.},
 pages = {43--53},
 title = {口腔癌の潜在性頸部リソパ節転移に関する臨床的,病理組織学的研究},
 volume = {62},
 year = {1993}
}