声门上型喉癌颈部转移淋巴结分型与对侧转移及预后关系的探讨  

The relationship between different types of lymph node metastasis and contralateral neck metastasis and their impact on prognosis

作　　者：关超[1] 郭星[1] 潘子民[1] 姜学钧[1] 

机构地区：[1]中国医科大学附属第一医院耳鼻咽喉科,沈阳110001

出　　处：《临床耳鼻咽喉头颈外科杂志》2010年第5期221-223,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨声门上型喉癌颈部转移淋巴结分型与对侧转移及预后的关系。方法:对248例术后随访资料完整的声门上型喉癌患者进行回顾性分析,术后均行颈廓清标本的病理连续切片,颈廓清标本采用透明淋巴结摘出连续切片法。分析不同临床病理因素与对侧转移的关系及生存分析。结果:115例标本发现有颈淋巴结转移,转移率为46.4%;其中单发型转移39例,多发型转移34例,融合型转移42例。单发型转移对侧转移率为5.1%,多发型为44.1%,融合型61.9%,对侧转移并且与肿瘤跨中线侵犯和临床N分级相关。单发转移患者3、5年生存率分别为79.5%和74.4%;多发转移患者3、5年生存率分别为61.8%和41.2%;融合转移患者3、5年生存率分别为61.9%和35.7%。结论:多发型和融合型转移患者应行对侧颈廓清术,颈淋巴结转移类型是判断患者预后的重要指标。Objective：To study the relationship between different types of lymph node metastasis and contralateral neck metastasis and their impacts on prognosis. Method：Two hundred and forty-eight patients with supraglottic carcinomas and complete follow-up were analyzed retrospectively.Transparent lymph node detection and continuous sectioning methods were applied on postoperative neck specimens.Result：Cervical lymph node metastases were found in 115 patients and the lymph node metastatic rate was 46.4%.There were three types of lymph node metastases, 39 cases with single type, 34 with multiple type,42 with fusion type. Contralateral metastatic rates were 5.1%, 44.1% and 61.9% in single, multiple and fusion type respectively. Contralateral metastasis was also related with tumor extension across midline and clinical N stages. The 3- and 5-year survival rates were 79.5% and 74.4% in single type, 61.8% and 41.2% in multiple type, 61.9% and 35.7% in fusion type.Conclusion：Bilateral neck dissections should be undertaken in multiple and fusion types of lymph node metastasis. The lymph node metastatic type should be an important criteria to judge prognosis.

关 键 词：喉肿瘤 淋巴转移 预后 

分 类 号：R739.6[医药卫生—肿瘤]