1997 Fiscal Year Final Research Report Summary
Diagnosis and treatment of cervical lymph node metastasis based on expression of cadherin-catenin complex
| Project/Area Number |
08457552
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Surgical dentistry
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| Research Institution | University of the Ryukyus (1997)
Sapporo Medical University (1996) |
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Principal Investigator |
HIRATSUAKA Hiroyoshi University of the Ryukyus School of Medicine Associate Professor, 医学部, 助教授 (50165180)
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| Co-Investigator(Kenkyū-buntansha) |
IDE Takashi Sapporo Medical University School of Medicine Assistant, 医学部, 助手 (70274933)
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| Project Period (FY) |
1996 – 1997
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| Keywords | Oral Cancer / Cervical Lymph Node Metastasis / Probability / α-カテニン |
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| Research Abstract |
Univariate and multivariate analyzes for occult lymph node metastasis (ONM) in 172 patients with clinically negative cervical lymph node metastasis were performed to elucidate the clinical and histologic tumor risk factors to enhance their ability to predict ONM.A multivariate Cox proportional hazards model and Hayashi's quantification theory type II were used to analyze prognostic factors and to determine the probability of ONM.Using Cox's proportional regression model, the factors linked to cancer specific survival were selected : tumor diferentiation (p=0.0330), mode of carcinoma invasion (p=0.0175), and ONM (p=0.0433). Pathologically identified metastatic lymph nodes were found in 21.5% of the cases studied (37 of 172 cases). The 5-year cancer specific survival was 94.0% for patients without lymph node metastasis, and 51.0% for patients with ONM (p<0.0001,1og rank test). The most siginificant predictors for ONM of each of the clinical and histologic factors, in descending order, were : mode of carcinoma invasion, intensity of lymphocytic infiltration, degree of differentiation, number of mitotic figures, and type of growth by means of Hayashi's quantification theory type II.The presence or absence of ONM in 147 of 172 patients (85.5%) was correctly predicted by the score at the point of intersection of the two curves, which was -0.03. Further investigation revealed that 28 of 32 new cases were differentiated accurately by means of this diagnostic system. The results of the present study suggest that this method of analysis can establish a reliable predictor of ONM,thereby facilitating correct choices for surgical procedures to enhance the survival rates of patients with clinically negative cervical lymph nodes.
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