喉鳞状细胞癌全喉切除术后复发和颈部转移  

Recurrence and Cervical Metastasis in Squamous Cell Carcinomas of the Larynx after Total Laryngectomy

作　　者：黄新生[1] 王建中[1] 谢晓凤[1] 黄风娥[1] 吴钦苏[1] 常荣先[1] 

机构地区：[1]复旦大学附属中山医院耳鼻喉科,上海200032

出　　处：《中国临床医学》2006年第5期858-859,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨喉鳞状细胞癌全喉切除术后的复发和颈淋巴结转移特点。方法:回顾分析108例因喉鳞状细胞癌行全喉切除手术的病例资料。结果:108例喉鳞状细胞癌患者有48例出现颈淋巴结转移,有8例局部复发,局部复发者预后差。48例出现颈淋巴结转移者中,有18例颈淋巴结转移发生于全喉切除手术之前,30例颈淋巴结转移发生于全喉切除手术之后。声门上型喉鳞状细胞癌比声门型容易发生颈淋巴结转移(P<0．01),T3和T4期患者比T2期患者客易发生颈淋巴结转移(P<0．01)。结论:颈淋巴结转移是喉鳞状细胞癌患者的常见现象,外科医师应警惕喉鳞状细胞癌颈淋巴结的高转移特性．并制定合适的治疗方案。对晚期和声门上型喉鳞状细胞癌应进行密切的术后随访。Objective：To study the characteristics of regional recurrence and cervical metastasis in squamous cell carcinomas of the larynx after total laryngectomy. Methods：A retrospective tumor registry analysis was made of 108 patients with squamous cell carcinomas of the larynx after total laryngectomy. Results： In 108 patients with squamous cell carcinomas of the larynx, cervical metastasis occurred in 48 patients and regional recurrence occurred in 8 patlents,patients with regional recurrence had a poor prognosis. Of 48 patients with cervical metastasis, 18 occurred before total laryngectomy,30 occurred after total laryngectomy. cervical lymph node metastases were related to tumor location and advanced initial tumor,lymph node metastases were significantly higher in supraglottic carcinomas than glottic carcinomas and in tumors staged T3 or higher than staged T2 （P〈0.01 ）. Conclusion：Cervical metastasis is a frequent appearance in squamous cell carcinomas of the larynx,The surgeon should be aware of the relatively high incidence of cervical metastases in patients with laryngeal squamous cell cancer to establish optimal treatment approaches. Intensive follow-up should be performed for patients with advanced initial tumor and supraglottic carcinomas after total laryngectomy.

关 键 词：喉肿瘤 喉切除术 淋巴结转移 复发 

分 类 号：R739.65[医药卫生—肿瘤]