声门上癌颈淋巴结转移的外科治疗  

Surgical Treatment of Cervical Lymph Node Metastasis of Supraglottic Carcinoma

作　　者：王旭东[1] 于洋[1] 

机构地区：[1]天津医科大学附属肿瘤医院头颈科,天津市300060

出　　处：《中国肿瘤临床》2005年第8期456-458,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨声门上癌颈淋巴结转移的特点及颈清术在声门上癌外科治疗中的应用。方法:分析210例声门上癌的颈淋巴结转移情况。结果:颈淋巴结转移率为47.6%,隐匿转移率为32.4%;行颈清术420例次,转移淋巴结535枚;不同肿瘤部位的转移率为:会厌室带51.9%,会厌33.3%,室带40.7%,杓会厌襞77.8%;不同肿瘤大小的转移率为:T114.7%,T237.7%,T353.4%,T477.6%;不同肿瘤分化程度的淋巴结转移率:G112.9%,G241.0%,G391.1%。结论:声门上癌的颈淋巴结转移与肿瘤的部位、大小(T)、分化程度(G)密切相关,转移淋巴结主要位于Ⅱ、Ⅲ区,Ⅱ区淋巴结应为前哨淋巴结,对临床N+病例应行根治性颈清术,对G3、T3和T4、杓会厌襞癌或累及杓会厌襞的声门上癌的临床N0病例应行肩胛舌骨肌上颈清术。Objective: To study features of cervical lymph node metastasis and application of neck dissection in surgical treatment of supraglottic carcinoma. Methods: A review of cervical lymph node metastasis of 210 patients with supraglottic carcinoma was performed. Results: The rate of cervical lymph node metastasis was 47.6% and occult metastatic rate was 32.4%; 535 metastatic lymph nodes were obtained in 420 neck dessection samples; Metastatic rate at different regions of the primary tumor included the metastasis rate of 51.9% for epiglotto-ventricular bands, 33.3% for epiglottis, 40.7% for ventricular fold and 77.8% for aryepiglottic fold, respectively; the metastatic rate for the primary tumor with different extents (T) included 14.7% for T1, 37.7% for T2, 53.4% for T3 and 77.6% for T4, respectively. The metastatic rate of the primary tumor with different grading (G) were G1 with metastasis rate of 12.9%, G2 with 41.0% and G3 with 91.1%. Conclusion: The cervical lymph node metastasis of supraglottic carcinoma is closely associated with region, extent and grading of the primary tumor, metastatic lymph nodes were mostly located in Ⅱ, Ⅲ level, radical neck dissection is recommended for N+ patient and supraomohyoid neck dissection seems justifiable for the treatment of N0 patient, especially for G3?T3, T4 and aryepiglottic fold carcinoma.

关 键 词：声门上癌 颈淋巴结转移 颈清术 

分 类 号：R739.6[医药卫生—肿瘤]