论文部分内容阅读
目的 :探讨声门上喉癌双侧颈淋巴结转移的临床病理特点。方法 :收集声门上喉癌伴颈淋巴结转移者 60例 ,其中单侧颈淋巴结转移和双侧颈淋巴结转移各 3 0例 ,根据肿瘤主体部位、肿瘤大小、表面形态、临床TNM分期、累及对侧半喉的程度、肿瘤分化程度、肿瘤边缘生长方式及会厌前间隙受累程度进行对比观察。结果 :单侧转移组和双侧转移组在 N0 期与 N2 期差异有显著性意义 ( χ2 =19.5 2 ,P<0 .0 5 ) ;双侧转移组中肿瘤累及对侧半喉中、重度比率明显高于单侧转移组 ( P<0 .0 5 ) ;临床 T4 期时 ,双侧转移组低分化者占 63 .6% ,高于单侧转移组的 10 % ,差异有显著性意义 ( P<0 .0 5 )。结论 :临床 T4 期时 ,如果肿瘤越过中线同时为低分化可考虑施行双侧颈廓清。对侧半喉受累中、重度的声门上喉癌者可考虑施行双侧颈廓清。临床 N2 及 N3病例应施行双侧颈廓清。
Objective: To investigate the clinicopathological features of bilateral cervical lymph node metastases in supraglottic carcinoma. Methods: Sixty patients with supraglottic carcinoma and cervical lymph node metastasis were collected, including 30 cases of unilateral neck lymph node metastasis and bilateral cervical lymph node metastasis. According to the tumor location, tumor size, surface morphology, clinical TNM stage, The degree of side half throat, the degree of tumor differentiation, the edge of tumor growth and the degree of involvement of the epiglottis gap were compared. Results: There was significant difference between N0 stage and N2 stage in unilateral metastasis group and bilateral metastasis group (χ2 = 19.5 2, P <0.05). In bilateral metastasis group, (P <0.05). At the T4 stage, 63.6% of the patients were poorly differentiated in the bilateral metastasis group, which was significantly higher than that of the unilateral metastasis group (P <0.05), which was significantly higher than that in the unilateral metastasis group (P <0. 05). Conclusions: At T4 stage, bilateral neck clearance may be considered if the tumor crosses the midline and is poorly differentiated. Lateral half throat involvement, severe supraglottic laryngeal cancer may consider the implementation of bilateral neck clearance. Clinical N2 and N3 cases should be implemented bilateral neck clearance.