原发性鳃裂癌4例临床分析  

Clinical study of 4 branchial cleft carcinomas

作　　者：邱宇[1] 林李嵩[1] 施斌[1] 朱小峰[1] 林耿冰[1] 黄立[1] 黄跃[1] 

机构地区：[1]福建医科大学附属第一医院口腔颌面外科福建医科大学面部整复与重建研究室,福建福州350005

出　　处：《中国口腔颌面外科杂志》2010年第5期468-472,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:通过病例分析,讨论鳃裂癌的临床特点、诊断标准和治疗方法。方法:回顾分析本院4例鳃裂癌病例的临床资料,结合国内外相关文献报道的病例,探讨鳃裂癌的临床特点,诊断、鉴别诊断要点,治疗方法及预后。结果:鳃裂癌主要表现为发生于鳃裂残余部位(多位于颈上部,胸锁乳突肌上1/3前缘)的快速增大的肿块。病理学特点为鳞状上皮恶变,以中、高分化鳞癌为主。镜下可见由正常上皮向重度不典型增生-原位癌-浸润癌过渡的变化过程,且缺乏淋巴结特征性结构的标志性特征。治疗以手术(肿瘤切除+同侧颈淋巴清扫术)为首选,辅以放化疗。本组4例患者除1例在随访6a后失访外,其余均存活。结论:鳃裂癌的诊断需慎重,要注意相关疾病鉴别。治疗以手术为主,辅助放化疗。早期手术(肿物扩大切除加颈淋巴清扫术)可提高治愈率及生存率。PURPOSE： To analyze the clinical characteristics, diagnostic criteria of branchial cleft carcinoma（BCC）and to discuss the management. METHODS： By a review of literature and 4 cases of BCC in our hospital, we presented a summary of the pathological and clinical data, diagnosis, differential diagnosis, treatment, as well as prognosis of BCC. RESULTS： The chief presentation of BCC was a quickly increasing mass existed in the branchial vestige. Squamous cell carcinoma was the most common pathologic type of BCC.Microscopically, transition from normal epithelium to severe atypical hyperplasia, carcinoma in situ, or invasive carcinoma could be found locally.Lymphoid structures could be identified but characteristic structures of lymph node were absent.After treated with surgery alone or surgery plus irradiation, 3 patients were still alive until now, while 1case lost of follow up after 6 years of follow-up. CONCLUSIONS：The diagnosis of a BCC requires the fulfillment of strict criteria.Metastatic carcinoma should be excluded before diagnosis of branchiogenic carcinoma.The prognosis of branchiogenic carcinoma is fairly wel1.Surgical excision of the neck mass is recommended for BCC. Early operation including extensive excision of the tumor and radical neck dissection could improve the cure rate and survival rate.

关 键 词：鳃裂癌 诊断 治疗 

分 类 号：R739.8[医药卫生—肿瘤]