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为探讨声门上型临床颈淋巴结阴性(cN_0)喉癌病人颈淋巴结转移规律并为外科治疗方式的选择提供理论根据,对35例cN_0声门上型喉癌被随机分为选择性根治性颈廓清(ERND)及选择性功能性颈廓清(EFND)两组,分别完成12及23例。ERND组平均每颈获取淋巴结32.5枚,EFND组29.8枚,差异不显著(t=0.86,P>0.05)。两组颈淋巴结转移率(pN~+)分别为33.3％(4/12)及30.4％(7/23),总转移率为31.4％(11/35)。11例颈淋巴结pN~+病例中有10例(90.9％)转移癌位于Level Ⅱ、Ⅲ。31枚阳性淋巴结中30枚(96.8％)位于Level Ⅱ和Ⅲ。Level Ⅰ、Ⅴ、Ⅵ均无癌转移。两组的3年生存率分别为66.7％(8/12)和82.6％(19/23),统计学差异不显著(x~2=1.1366,P>0.25),总的3年生存率为77.1％(27/35)。根据本研究结果,笔者认为对cN_0声门上型喉癌行主病变侧肩胛舌骨肌上或同侧颈廓清较为适宜。
To investigate the regularity of cervical lymph node metastases in patients with supraglottic cervical lymph node-negative (cN_0) laryngeal cancer and to provide a theoretical basis for the selection of surgical treatment, 35 cases of cN_0 supraglottic laryngeal carcinoma were randomly divided into selective radical neck There were 12 and 23 cases of ERND and EFND respectively. There were 32.5 lymph nodes per neck in the ERND group and 29.8 in the EFND group, with no significant difference (t = 0.86, P> 0.05). The rates of cervical lymph node metastasis (pN ~ +) in the two groups were 33.3% (4/12) and 30.4% (7/23) respectively, and the total metastasis rate was 31.4% (11/35). Ten cases (90.9%) of 11 cases of cervical lymph node metastasis were located in Level Ⅱ, Ⅲ. Thirty (96.8%) of the 31 positive lymph nodes were located in Level II and III. Level Ⅰ, Ⅴ, Ⅵ no cancer metastasis. The 3-year survival rates of the two groups were 66.7% (8/12) and 82.6% (19/23) respectively, with no significant difference (x ~ 2 = 1.1366, P> 0.25). The overall 3-year survival rate was 77.1 % (27/35). According to the results of this study, I believe that cN_0 supraglottic carcinoma of the main lesion lateral scapular muscle or ipsilateral neck clearance is appropriate.