跨声门癌生长扩展特点的组织病理学研究  

Histopathological study of local invasiveness of transglottic cancer

作　　者：吕威[1,2] 任重[1,2] 潘子民[1,2] 柳斌 

机构地区：[1]中国医科大学第一临床学院耳鼻咽喉科 [2]北京协和医院耳鼻咽喉科

出　　处：《中华肿瘤杂志》1998年第4期299-301,共3页Chinese Journal of Oncology

摘　　要：目的探讨跨声门癌侵及声门旁间隙和会厌前间隙的特点及相关因素。方法对５０例跨声门癌全喉切除标本的连续切片进行观察分析。结果声门旁间隙的受累率为７８．０％（３９／５０），其中以超出该间隙受累较多，为８２．１％（３２／３９）。超出声门旁间隙的病例累及周围组织的频度为：弹力圆锥８１．３％（２６／３２），甲状软骨７５．０％（２４／３２），环甲膜６２．５％（２０／３２）。会厌前间隙的受累率为４６．０％（２３／５０）。随着肿瘤Ｔ分级的增高、肿瘤的增大，声门旁间隙及会厌前间隙的受累率增加。结论跨声门癌中，声门旁间隙易受累，并易突破该间隙。肿瘤可以通过声门旁间隙向前上或由前联合向上破坏会厌软骨根部两条途径侵入会厌前间隙。Ｔ３、Ｔ４级肿瘤、大小超过２０ｍｍ以上者，应慎行部分喉切除术。Objective To explore the characteristics and relevant factors of transglottic cancer invading paraglottic space (PGS) and pre epiglottic space (PES). Methods Whole organ serial sections of 50 transglottic cancer specimens were studied histopathologically. Results Transglottic cancer invading PGS was observed in 39 of the 50 (78.0%) specimens. In 32 of the 39 specimens, the invasion outstripped PGS, involving elastic cone in 26(81.3%), thyroid cartilage in 24(75.0%) and cricothyroid membrane in 20(62.5%). Transglottic cancer invading PES was seen in 23 of the 50 specimens (46.0%). With the increase in tumor staging and tumor size, PGS and PES became increasingly invaded. There were two possible routes of invasion to PES: a) extending anteriorly and upward via PGS; b) extending upward via anterior commissure to destroy the stem of epiglottic cartilage. Conclusion PGS is easily invaded by transglottic cancer. Partial laryngectomy is recommended in patients with T 3, T 4 transglottic cancer larger than 20 mm in diameter.

关 键 词：喉肿瘤 病理学 喉切除术 跨声门癌 

分 类 号：R739.650.2[医药卫生—肿瘤]