tongue cancer
Introduction
Introduction to tongue cancer Tongue cancer is the most common oral cancer, more men than women. Most of the tongue cancers are squamous cell carcinoma, especially in the 2/3 front part of the tongue. Adenocarcinoma is rare, mostly located in the base of the tongue. Lymphatic epithelial cancer and undifferentiated carcinoma can sometimes occur in the base of the tongue. Tongue cancer occurs mostly at the edge of the tongue, followed by the tip of the tongue, the back of the tongue and the base of the tongue. It is often ulcerated or infiltrated. Generally, the degree of malignancy is high, the growth is fast, the infiltration is strong, and the tongue muscle is often spread, resulting in limited movement of the tongue, which makes it difficult to speak, eat and swallow. Tongue cancer can invade the lingual arch and tonsil in the posterior, and the advanced tongue cancer can spread to the bottom of the mouth and the jaw bone, so that the whole tongue is fixed. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: cervical lymph node tuberculosis
Cause
Cause of tongue cancer
The etiology of oral cancer has not yet been fully understood, but the current consensus is that most oral cancers are related to environmental factors. Some external factors such as heat, chronic damage, ultraviolet rays, X-rays and other radioactive substances can become carcinogenic factors. For example, tongue and buccal mucosa cancer can occur in long-term, often irritating sites such as residual roots, sharp cusps, and poor prostheses. In addition, internal factors such as neuropsychiatric factors, endocrine factors, immune status of the body, and genetic factors are all It has been found to be associated with the development of oral cancer. Before the onset of oral cancer, there is usually a stage of precancerous lesions, such as oral leukoplakia, traumatic ulcer, and mastoid tumor.
Prevention
Tongue cancer prevention
1, pay attention to oral hygiene, to brush your teeth every morning and evening, rinse your mouth after meals.
2. If there is a cavity that should be filled early, the residual crown and roots that can be repaired should be treated in time to restore the normal anatomy of the tooth earlier.
3. Grind and sharp the non-functional cusps and edge ridges, so that the cusps and edge ridges of the crown occlusal surface become round and blunt to prevent damage to the lingual edge tissue.
4, found that benign lesions or precancerous lesions, such as papillary papilloma or erosive lichen planus, etc., should be promptly removed biopsy, or active treatment, regular observation.
5, quit smoking, alcohol abuse and other bad habits, strengthen physical exercise, improve nutrition, eat more fresh fruits rich in vitamins and anti-cancer, anti-cancer effect, eat less irritating food.
Complication
Tongue cancer complications Complications, cervical lymph node tuberculosis
The tongue lymph node metastasis often occurs in the tongue cancer, and the metastasis is earlier. The metastasis mainly occurs on the same side. However, although the primary lesion is confined to one side, the lymphatic vessels in the central part of the tongue can be drained to the double neck, and bilateral metastasis occurs. The rate of double-neck transfer of the lesion over the midline can be doubled.
Symptom
Tongue cancer symptoms Common symptoms Tongue movement restricted dysphagia Circulating pharyngeal dyskinesia Skull area has swelling and tenderness Tongue painful millet... Tongue pain in the back of the back of the black tuft
Symptoms and signs
Early tongue cancer can be manifested as three types of ulcer, exogenous and invasive. The first symptom of some cases is only tongue pain, sometimes reflected to the ankle or ear. The exogenous form can be derived from malignant transformation of papilloma. Invasive surface can be free of protrusions or ulcers, which is most likely to delay the disease, and patients often cannot find it early.
Tongue cancer is often characterized by ulceration and infiltration, accompanied by spontaneous pain and varying degrees of tongue movement disorder. Late tongue cancer can directly transcend the midline or invade the fundus, as well as invade the lingual periosteum, bone plate or bone of the mandible. Later, it can extend to the base of the tongue or the anterior column of the pharynx and the side wall of the pharynx. At this time, the movement of the tongue can be severely restricted and fixed, and the sputum increases and overflows, but it cannot be controlled automatically. It is difficult to eat, swallow, and speak. The pain is severe and can be reflected to the half of the head. The lymph node metastasis rate of tongue cancer is high, usually about 40%. The metastatic site has the largest number of lymph nodes in the neck. From the tongue to the advanced stage, lung metastasis or distant metastasis of other parts may occur.
The latest tnm staging protocol for tongue cancer (including tongue and tongue root). Excerpted from the National Anti-Cancer Alliance (uicc) and the American Anti-Cancer Association (ajcc), the tnm staging of head and neck tumors began on January 1, 1987.
Staging of primary cancer (t)
T1s = carcinoma in situ.
T1 = tumor with a maximum diameter of 2 cm or less.
T2 = tumor maximum diameter greater than 2 cm, but not more than 4 cm.
T3 = tumor maximum diameter greater than 4 cm.
T4 = Tumors (regardless of size) invade adjacent structures, such as invading the cortical bone, deep muscles of the tongue (extralingual muscles), maxillary sinus, and skin.
Staging of cervical lymph node metastasis (n)
N0 = no significant metastasis of local lymph nodes.
N1 = ipsilateral single lymph node metastasis with a maximum diameter of 3 cm or less.
N2 = ipsilateral single lymph node metastasis, the maximum diameter is greater than 3cm, but less than 6cm; or multiple lymph node metastasis on the same side, but the maximum diameter is less than 6cm; or bilateral or contralateral lymph node metastasis, but the maximum diameter is not greater than one 6cm.
N2a = ipsilateral single lymph node metastasis with a maximum diameter greater than 3 cm but less than 6 cm.
N2b = multiple lymph node metastasis on the same side, but no larger diameter than one greater than 6 cm.
N2c = bilateral or contralateral lymph node metastasis, but no larger diameter than one greater than 6 cm.
N3 = metastatic lymph nodes with a maximum diameter of more than 6 cm.
Staging of distant transfer (m)
Mx=There is no way to determine if there is a distant transfer.
M0 = no significant distant metastasis.
M1=There is a distant transfer.
Tnm=clinical staging
0 phase tisn0m0
Phase I t1n0m0
Phase II t2n0m0
Phase III t3n0m0; t1-3n1m0
Stage IV t4n0-1m0; t1-4n2-3m0; t1-4n0-3m1
Examine
Examination of tongue cancer
1. For clinical manifestations, the tumor is more limited than the ones to check the project to check the frame limit "A";
2. For the atypical clinical manifestations, the differential diagnosis is more difficult, and the larger the tumor is closely related to the surrounding important structure or the suspected metastatic examination project may include the check boxes "B" and "C".
3. Perform a tissue biopsy.
Diagnosis
Diagnosis and diagnosis of tongue cancer
diagnosis
Diagnosis can be made based on medical history, clinical manifestation, and examination.
Diagnostic identification
Tongue cancer should be differentiated from the following diseases:
1. Traumatic ulcers, more common in the elderly, occur in the posterior margin of the tongue, often have stimulants in the corresponding parts, the ulcer is deep, the surface has a gray-white pseudomembrane, the base is not hard, the irritant can be healed if necessary, if necessary For biopsy, for early diagnosis and treatment.
2. Tuberculous ulcers, which occur mostly in the back of the tongue, occasionally on the tip of the tongue and the edge of the tongue. The ulcer is superficial, purple-red, and the edges are not uniform. The sneak damage of the small bite of the mouse bite is small, the base is not infiltrated, and there is no tuberculosis. Medical history.
