下咽癌颈淋巴结转移区域探讨  

Distribution of cervical lymph node metastasis in hypopharyngeal carcinoma

作　　者：黄新辉[1] 彭江涛[1] 袁宏伟[1] 

机构地区：[1]漯河市中心医院耳鼻咽喉科,河南漯河462000

出　　处：《中国耳鼻咽喉颅底外科杂志》2011年第6期434-437,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的研究下咽癌颈淋巴结转移区域的特点及术后治疗策略。方法回顾性分析2004年7月～2008年7月于我科住院治疗的18例下咽癌患者的临床资料,18例患者均行手术治疗,术前未行放疗或化疗,将术中肿瘤原发灶及根治性颈廓清术中的颈淋巴结标本按区域标记逐一进行病理观察,确定肿瘤原发部位及颈淋巴结转移区域。术后随访3～5年,观察淋巴转移与患者的关系。结果 18例下咽癌颈淋巴结转移率为88.9%(16/18);颈淋巴结转移的主要区域为LevelⅡ区、LevelⅢ区,转移率分别为73.1%、69.2%;其次为LevelⅣ区8.3%,未发现LevelⅠ区、LevelⅤ及LevelⅥ区淋巴结转移。结论下咽癌颈淋巴结转移率较高,转移区域同侧为主,以LevelⅡ、LevelⅢ区常见。颈淋巴结位置的下移和转移淋巴结的直径与患者的预后呈正相关。Objective To investigate the characteristic of cervical lymph node metastasis of hypopharyngeal carcinoma, so as to find appropriate postoperative treatment strategies and improving outcome. Methods The clinical data of 18 eases of hypopharyngeal carcinoma from July 2004 to July 2008 were analyzed retrospectively. All patients received operation without pre-operative chemotheraphary or radiotheraphy. The marking specimens from the operation were carefully examined to firm the primary tumor and the distribution of cervical lymph node metastasis. Prognosis and metastasis were observered through the follow-up period ranged from 3 ~ 5 years. Results The total rate of regional cervical lymph node metastasis for 18 patients was 88. 9 % （ 1 6 / 1 8 ） and the highest rates of postive lymph nodes were at Level Ⅱ （ 7 3 . 1% ） and Level Ⅲ （69.2%）. Metastasis to Level IV （8.3%） was rare and no metastic lymph nodes in Level Ⅰ , LeveⅣ , Level Ⅵ. Conclusion Cervical lymph node metastasis rate of hypopharyngeal earcinomal is high, primarilly in the homolateral side. The highest rates of postive lymph notes are at Level Ⅱ and Level Ⅲ . With the increase of the diameter and the downward shift location of metastatic cervical lymph nodes, the prognosis of the patients declined gradually.

关 键 词：下咽癌 颈淋巴结转移 预后 

分 类 号：R739.6[医药卫生—肿瘤]