摘要
目的探讨声门上型喉癌患者颈淋巴结隐匿性转移的特点和颈部淋巴清扫区域及范围。方法 89例声门上型喉癌颈淋巴结临床诊断阴性患者行喉切除术同时行选择性颈清扫术。对清扫的淋巴结分区域进行病理连续切片观察,明确转移及复发区域。结果 89例患者32例有转移,转移率36％。发现61 枚有转移的淋巴结分布在：Ⅰ区1枚,Ⅱ区42枚,Ⅲ区13枚,Ⅳ区4枚,Ⅴ区1枚,Ⅵ区未见转移。其中Ⅱ、Ⅲ区共55枚,占转移数90.2％。颈部复发6例分别于Ⅱ、Ⅲ、Ⅳ区,复发率6.7％。结论声门上型喉癌患者颈淋巴结隐匿性转移率较高,而早期临来诊断较难,故临床处理应积极行选择性区域性颈清扫术,而重点行Ⅱ、Ⅲ区颈淋巴结清扫术。
Objective To study the pathologic feature of occult lymphatic metastasis in patients with supraglottic carcinoma and explore reasonable dissection of cervical lymph node.Methods The 89 patients with supraglottic carcinoma were recruited. Radical dissections of cervical lymph node were performed in cases with pathologic negative node. Each lymph node was studied pathologically in serial sections in order to define the level of the lymphatic metastasis and area of recurrence.Results The metastasis rate was 36% （38/89）.61 metastasis lymph nodes histologically were harvested. The distribution of metastasis lymph nodes was 1 in Ⅰ level,42 in Ⅱ level,13 in Ⅲ level,4 in Ⅳ level,1 in Ⅴ level and 55 lymph nodes were lactated in the Ⅱ, Ⅲ level,acount for 90.20% of metastasis numbers.Cervical recurrence occurred on the 6 cases in the Ⅱ, Ⅲ and Ⅳ level respectively,the recurrence rate was 6.7%. Conclusion Occult metastasis rate of supraglottic carcinoma is relatively higher, and it is difficult to make early diagnosis. So selective neck dissection is recommended for clinical treatment of this disease, and Ⅱ,Ⅲ level should be dissected.
出处
《实用医药杂志》
2006年第1期27-29,共3页
Practical Journal of Medicine & Pharmacy
关键词
喉肿瘤
淋巴转移
喉切除术
颈淋巴结清扫术
Laryngeal neoplasms Lymphatic metastasis Laryngoectomy Radical neck dissection
