论文部分内容阅读
目的:通过病例分析,讨论鳃裂癌的临床特点、诊断标准和治疗方法。方法:回顾分析本院4例鳃裂癌病例的临床资料,结合国内外相关文献报道的病例,探讨鳃裂癌的临床特点,诊断、鉴别诊断要点,治疗方法及预后。结果:鳃裂癌主要表现为发生于鳃裂残余部位(多位于颈上部,胸锁乳突肌上1/3前缘)的快速增大的肿块。病理学特点为鳞状上皮恶变,以中、高分化鳞癌为主。镜下可见由正常上皮向重度不典型增生-原位癌-浸润癌过渡的变化过程,且缺乏淋巴结特征性结构的标志性特征。治疗以手术(肿瘤切除+同侧颈淋巴清扫术)为首选,辅以放化疗。本组4例患者除1例在随访6a后失访外,其余均存活。结论:鳃裂癌的诊断需慎重,要注意相关疾病鉴别。治疗以手术为主,辅助放化疗。早期手术(肿物扩大切除加颈淋巴清扫术)可提高治愈率及生存率。
Objective: To discuss the clinical features, diagnostic criteria and treatment of gill lysis by case analysis. Methods: The clinical data of 4 cases of gill carcinoma in our hospital were retrospectively analyzed. The clinical features, diagnosis and differential diagnosis points, treatment methods and prognosis of gill carcinoma were discussed in combination with the cases reported from domestic and foreign literature. RESULTS: The branchial gills mainly manifested as a rapidly growing mass in the remnants of the branchial cleft (mostly in the superior cervical upper part of the upper third of the sternocleidomastoid). Pathological features of squamous epithelial malignant, mainly in the well-differentiated squamous cell carcinoma. Microscopic changes from normal epithelium to severe atypical hyperplasia - carcinoma in situ - infiltrating carcinoma were observed, and the hallmark features of the characteristic structures of lymph nodes were absent. Treatment of surgery (tumor resection plus ipsilateral neck dissection) as the first choice, supplemented by radiotherapy and chemotherapy. Four patients in this group except 1 patient were followed up for 6 years and then lost, the rest survived. Conclusion: The diagnosis of gill fissure cancer should be cautious, pay attention to the identification of related diseases. Surgical treatment-based, adjuvant radiotherapy and chemotherapy. Early surgery (enlarged tumor resection plus cervical lymphadenectomy) can improve the cure rate and survival rate.