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]河南漯河市中心医院耳鼻咽喉科,462000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2012年第1期45-46,66,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

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,改善预后。方法回顾性分析2002年7月～2008年7月于我科住院治疗的35例下咽癌患者的临床资料,29例患者均行手术治疗,且术前未行放疗或化疗,将术中肿瘤原发灶及颈清扫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。通过随访3～5年,观察转移及预后。结果 29例下咽癌总的颈淋巴结转移率为86.2%(25/29),颈淋巴结转移的主要区域为LevelⅡ区、LevelⅢ区,转移率为73.8%、69.0%,其次为LevelⅣ区7.7%,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。随着颈淋巴结位置的下移及转移淋巴结直径的增大,患者的预后越来越差。Objective To investigate the characteristic of cervical lymph node metastasis of hypophatyngeal carcinoma, so as to find appropriate postoperative treatment slrategies and improving outcomes. Methods The clinical data of 35 cases of hypopharyngeal carcinoma from July 2002 to July 2008 were analyzed retrospectively .29 patients received operation without pre-operative chemotheraphary or radiotheraphy, the marking specimens from the operation were carefully examined to th＇m the primary tumor and the distribution of cervical lymph node metastasis. Prognosis and metastasis were observered through the follow-up period range from 3-5 years .Results The total rate of regional cervical lymph node metastasis for 29 patients was 86.2% （ 25/29 ） and the highest rates of postive lymph nodes was at Level II （73.,8 %）. LevelIII（69.0%）.Metastasis to LevelIV（7.7%） was rare and without metastic lymph nodes in Level I . LevelV and LevelVI.Condusions Cervical lymph node metastasis rate of hypopharyngeal carcinomal is high. and primarilly the homolateral side . The highest rates of postive lymph notes are at Level II and Levelnl.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：R739.63[医药卫生—肿瘤]