Disease Overview
tonguecarcinomais发lifeintongueregionofmalignant tumor，isoralcarcinomainthe most commontype，accounting fororalcarcinomaof30%-50%。tonguecarcinomacommonly occurs intongueLateral border,particularlytongueanterior2/3of活moveregion，secondastongueVentral,tongueDorsal.more common in males，male-to-female ratioapproximately2:1，peak age of onset40-60years old。tonguecarcinomawithsquamous cell carcinomaas主(accounting for90%and above)，degree of malignancyrelativelyhigh，easy发lifelymph nodesmetastasis，prognosis相forrelativelyPoor,5yearsurvival rateapproximately50%-60%。early-stageDiagnosisandcomprehensivetreatmentisimprovesurvival rateofcloseKey.
Major Causes
Smoking：long-termSmokingistonguecarcinomamost importantofrisk factor，Smokingthoseincidence riskisnotSmokingthoseof5-25times。
Alcohol consumption：long-termextensiveAlcohol consumption，andSmokinghavesynergistic致carcinomaeffect，risksignificantincreasing。
Betel nut chewing：inSoutheast AsiaandChinaSouthern regions,long-termchewingbetel nutthoseincreased risk20-30times。
Physical irritation：residual root, Residual crown,adverserepairbodylong-termFrictiontongueBorder,canInducingcarcinomachange。
Viral infection: Human papillomavirustumordiseasetoxin(HPV)infectionandtonguecarcinomarelated，especiallyHPV16/18type。
Nutritional deficiency: VitaminlifeelementA、BB complex,C、Eetc.Deficiency,oralmucosaBarrierfunctionunderdecrease。
Immunosuppression：HIVinfection、organTransplantation,long-termenablingusingImmunosuppressionAgents.
Genetic factors：haveoralcarcinomafamily historythoseincreased risk。
Poor oral hygiene：oral卫lifeadverse、chronic inflammatory stimulation。
Common Symptoms
early-stagesymptoms：
tongue缘ortongue腹smallulcer：long-termnot愈combine, Marginselevated
leukoplakia、erythroplakia：mucosasurface白coloror红color斑
rough thickening：mucosasurfaceRough,increasethick
mildpain：intermittentStinging painorBurning pain
progressive-stagesymptoms：
persistentpain：tumorincreaselargeorSecondaryinfectioncausing
mass：tongueregion触andfirm, Marginsnotclearofmass
bleeding：ulcersurfacebleedingorSpontaneoustypebleeding
dysphagia：Tumor invadestongue根ormouth底impactfunction
Speech impairment:tonguecarcinomacausingtonguemotorreceiveLimitation, speechnotclear
cervicalsymptoms：
颈lymph nodesenlargement：approximately30%-50%patientsat presentation已havecervicallymph nodesmetastasis
cervicalpain：lymph nodesmetastasisorinvasionsurroundingtissue
advanced-stagesymptoms：
advancefood困difficult, Swallowingpharynxpain
ZhangmouthreceiveLimitation:invasion翼internal肌
painradiation至earregion
cachexia：emaciation、fatigue、anemia
Pathological Classification
squamous cell carcinoma(90%and above)：degree of differentiationfromwell-differentiatedtoundifferentiated
verrucous carcinoma：lowdegree恶type，relatively少metastasis
glandularcarcinoma：rare，to源intongueglandularbody
undifferentiated carcinoma：high degree of malignancy
othertype：basal cell carcinoma、neuroendocrine tumorsetc.
TNM Staging(AJCC8th edition)
Primary Tumor (T)
Tis：Carcinoma in situ
T1：tumormaximum diameter≤2cm，depth of invasion≤5mm
T2：tumor>2cmbut≤4cm，oranysizedepth of invasion>5mmand≤10mm
T3：tumor>4cm，oranysizedepth of invasion>10mm
T4a：Tumor invadesAdjacentstructure(such asunder颌bone, Alveolarbone、tongueexternal肌)
T4b：Tumor invadeschewingIntermuscular spaces, pterygoid platesorskull baseand/orEncasing the carotid arteryinternalmove脉
Regional Lymph Nodes (N)
N0：No regional lymph node metastasis
N1：ipsilateral单lymph nodesmetastasis，≤3cm
N2：ipsilateralmorelymph nodesmetastasis≤6cm，orcontralaterallymph nodes≤6cm
N3：metastasislymph nodes>6cm
Distant Metastasis (M)
M0：No distant metastasis
M1：Distant metastasis present
Clinical Stage Grouping
0stage：TisN0M0
Ⅰstage：T1N0M0
Ⅱstage：T2N0M0
Ⅲstage：T3N0M0，T1-3N1M0
ⅣAstage：T4aN0-2M0，anyTN1-2M0
ⅣBstage：T4banyNM0，anyTN3M0
ⅣCstage：anyTanyNM1
Diagnosis
oralexamination: Visual inspection, palpationfoundtongueregionlesion
biopsypathological：gold standard，bright确Diagnosisandpathologicaltype
Imaging studies：
ultrasound：assessmenttongueregionmassandcervicallymph nodes
CT/MRI：assessmenttumordepth of invasion、surroundingtissueinvasion、lymph nodesmetastasis
PET-CT：distantmetastasisscreening
move脉perfusion+embolization：minimally invasive interventional therapyrewritingtonguecarcinomaFate
througharterial infusion chemotherapy+embolizationachieveprecision strike：
超choiceCatheterization: MicrocatheterDirectly reachingtumorfeeding artery(such astonguemove脉);
high浓degreedrugperfusion：localdrug浓degreerelativelystatic脉chemotherapyhigh10times，directly“toxinKill”carcinomacells;
embolizationfeeding vessels：cut offtumorNutritional pathway, “starvedeath”residuallesion。
technologyadvantage：
minimally invasivenoPain:no需openKnife,postoperatively1天namelycanadvancefood;
fast速reliefsymptoms：Su Huayipostoperatively3天tongue痛significantdecreaselight;
reducemetastasisrisk：embolizationblockcarcinomacellsspreadpathway。
Prevention and Follow-up
quit smoking and limit alcohol：mosteffectiveofpreventionmeasures
Refusedbetel nut：avoidlong-termchewingbetel nut
oral卫life：regularlyoralexamination，andtimehandleresidual root、adverserepairbody
healthy diet：more吃newFresh fruits and vegetables,reducepickled、smoked and grilledfood品
HPVVaccinationtype：canpreventionHPVrelatedtonguecarcinoma
early-stagethenClinic:tongueregionulcerexceeding2周not愈combine应andtimethen医
follow-up：after treatmentfirst 2 yearsevery 3 monthsonce，years 3-5every 6 monthsonce，after 5 yearsannuallyonce