声门下癌的临床及病理分析  

Clinical and pathological analysis of subglottic cancer

作　　者：韩瑞珠[1] 张冬梅[1] 金德均[1] 李晓丹[1] 陆路[1] 董春梅[1] 王久莉[1] 

机构地区：[1]哈尔滨医科大学附属第二医院耳鼻咽喉科,黑龙江省嫩江县山河农场医院

出　　处：《耳鼻咽喉（头颈外科）》1996年第1期30-32,共3页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：本文将１９７８～１９９０年临床、病理及随访资料完整的１５例声门下型喉癌病例进行回顾性分析。整喉以冠状切面行冠状连续切片，对其进行病理组织学研究，并结合临床分析，阐明：①声门下癌具有发病率低、病程长、发现晚的特点；②声门下鳞癌的生长方式主要为浸润型生长及丛生浸润型生长，病理分级为Ⅱ、Ⅲ级，病理分期为Ｐ３、Ｐ４；③声门下癌局限于声门下区而不向声门上扩展，侵及甲构肌致声带固定，并经环甲膜向喉外扩散。淋巴结转移主要转移到喉前、气管旁及颈深淋巴结下群；④声门下癌临床主要症状为声嘶，其次为呼吸困难和喘鸣。诊断须依据临床症状、纤维喉镜检查及喉部ｘ线体层摄片，必要时行喉裂开术，术中冰冻切片。手术方式均行全喉切除术。Abstract Fifteen cases of subgottic cancers were submitted to total laryngectomy and the excisedlaryngeal cancer samples were serial coronally sectioned for histopathological studies.By cli-nical analysis, the results were as follows:1.The morbidity of subglottic cancer was low.The tumors appeared to be of long duration and slow progressive growth.The diagnosis ofthe cancer is made bv endoscopy,X-ray study as well as tomograms of the larynx and tra-chea or by CT scan of the neck.Sometimes the diagnosis is made by neck biopsy.2.As forthe infiItrating growth mode and the plexiformal infiltrating growth mode of squamous cellcarcinomas, their p-stage are usually P4 and P3, their pathological grading are usually grade-Ⅲ。3.Subglottic cancers often invade local tissues,such as thyroid cartilage,thyroid gland,cricoid cartilage, and traches. They can pierce cricothyroid membrane to infiltrate tissues outof the membrane,but distant metastasis of the tumor was rare.4.Clinical symptoms of sub-glottic cancer are as follows:hoarsess,wheeziness, dyspnea and pain often of long duration.The recommended treatment of the tumor is total laryngectomy with excision of trachea 1～4.Radiotherapy is an effective adjunct for recurrence and metastasis of the tumor

关 键 词：喉肿瘤 病理学 声门下癌 

分 类 号：R739.650.2[医药卫生—肿瘤]