摘要
目的 :探讨声门型喉癌术后局部复发与颈淋巴结转移的特点及预防措施。方法 :回顾性分析 76例T1～T3 期声门型喉癌的临床资料 ,对其中 5 6例T2 ～T3 期声门型喉癌通过逐步回归的方法比较肿瘤的侵犯部位与术后淋巴结转移方向、局部复发、肿瘤分期和颈淋巴结清扫的关系。通过 χ2 检验分析 76例T1～T3 期声门型喉癌肿瘤是否侵犯前连合与局部复发的关系。结果 :随访 3年 ,1年和 3年生存率分别为 97.4%和 92 .1%。术后有 11例发生局部复发和 (或 )颈淋巴结转移。肿瘤侵犯前连合 35例 ,6例 (17.1%)局部复发 ,余 41例未累及前连合者 ,无一例局部复发。肿瘤向声门下扩展超过 5mm者 12例 ,有 3例发生气管旁淋巴结转移 ,1例颈下深淋巴结转移 ;肿瘤向声门上侵及喉室顶或假声带者 8例 ,术后 1例发生颈上深淋巴结转移 ,1例颈中深淋巴结转移 ;余36例术后只有 1例发生颈中深淋巴结转移。经逐步回归分析 ,发现肿瘤的侵犯部位与术后颈淋巴结有无转移及淋巴结的转移部位和肿瘤的分期有关 (P <0 .0 5 )。结论 :声门型喉癌若肿瘤向声门下侵犯 ,易发生气管旁和颈下深淋巴结转移 ;肿瘤若侵及前连合可增加局部复发的可能 (P >0 .0 5 )。
Objective:To study the feature and prevention of local recurrences and nodal metastases of glottic carcinoma after operation. Method:Seventy-six patients with glottic carcinoma were reviewed retrospectively. The relationship among the region involved by cancer, local recurrences, tumor stage and neck dissection was compared with multiple-factors stepwise regression. The relationship between the region involved by cancer and local recurrences was compared with chi-square test .Result: In this group of 76 patients with glottic carcinoma had been followed-up for 3 years, the 1-year and 3-year survival rate were 97.4% and 92.1%. Eleven had occurred local recurrences and/or cervical lymph node metastases after operation.Six of thirty-five patients (17.1%) whose anterior commissure was involved had recurrences during the follow-up period. There were no local recurrences in another 41 patients. Three of twelve patients whose glottic tumors with subglottic extension (extension more than 5mm below the glottiis ) were found paratracheal lymph node (PTLN) metastases, one of which was lower jugular lymph node metastases.The glottic tumors with supraglottic extension or glottic tumors with subglottic extension which invaded less than 5 mm weren't found PTLN metastases. By analysis of stepwise regression , it was found if there were the metastases of PTLN and lower jugular lymph node ,the tumor often extend to the subglottic (P<0.05). There is no difference between local recurrences and the tumor with or without involved anterior commissure (P>0.05). Conclusion:The glottic cancers with subglottic extension may occur PTLN and lower jugular lymph node metastases.The glottic cancers with involved anterior commissure are considered to be more at risk for local recurrences.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2003年第9期529-531,共3页
Journal of Clinical Otorhinolaryngology
关键词
喉肿瘤
喉切除术
肿瘤复发
局部
淋巴结转移
Laryngeal neoplasms
Laryngectomy
Neoplasm recurrence,local
Lymph node metastases
