声门型喉癌CO_2激光手术治疗后局部复发与前联合受侵犯的关系  

Relationship between Local Recurrence and Anterior Commissure Involvement after CO_2 Laser Endoscopic Resection

作　　者：刘学奎[1] 刘志民[1] 刘巍巍[1] 李秋梨[1] 李浩[1] 欧阳电[1] 李铨[1] 张欣睿[1] 郭朱明[1] 曾宗渊[1] 

机构地区：[1]中山大学肿瘤防治中心头颈科,华南肿瘤学国家重点实验室,广州市510060

出　　处：《中国肿瘤临床》2012年第22期1810-1813,共4页Chinese Journal of Clinical Oncology

基　　金：广东省科技计划项目(编号:2011B031800221)资助

摘　　要：目的:分析CO_2激光手术治疗声门型喉癌局部复发与前联合受侵犯的关系。方法:回顾性分析2008年1月至2010年12月中山大学肿瘤防治中心中133例激光手术治疗的早期声门型喉癌患者资料。其中包括侵犯前联合患者48例和前联合未受侵85例。133例中原位癌(T_(is))40例,T_(1a)58例,T_(1b)19例,T_25例,T_31例。术后随诊6～42个月。比较前联合受累组与前联合未受累组的局部复发率。结果:133例支撑喉镜下CO_2激光手术后21例局部复发,局部复发率为15.79%(21/133)。其中T_(is)复发率为17.50%(7/40)、T_(1a)为8.62%(5/58)、T_(1b)为36.84%(7/19)、T_2为13.33%(2/15),T_31例无复发,各组间复发率无显著性差异(P>0.05)。病变侵犯前联合复发率为25.00%(12/48),病变未侵犯前联合复发率为10.59%(9/85),两组间有显著性差异(P<0.05)。133例激光手术治疗患者中死亡4例。结论:激光手术治疗侵犯前联合的早期声门型喉癌复发率高,其治疗价值值得进一步研究。Objective： This work aims to analyze the relationship between local recurrence and location of the tumor in early glot -tic carcinoma after CO2 laser endoscopic resection. Methods：Data of133 early glottic carcinoma cases, which were treated with laser surgery and were hospitalized at the cancer center of Sun Yan-Sen University from 2008to 2010, were reviewed retrospectively. Of the 133 cases, 48involved the anterior commissure and the other 85did not. Of the total cases, Tis stage lesion （tumor in situ） was found in 58cases, T1a stage in58, T 1b stage in19, T2 stage in15, and T3 stage in only1. The follow-up period ranged from 6 to 42months. The lo-cal recurrence rate between the involvement and non-involvement of anterior commissure was compared. Results： Local recurrence was detected in21of the 133 cases with early glottic laryngeal carcinoma after CO2 laser surgery. The local recurrence rate was 15.79% （21/133）. The recurrence rates of T1a, T1b, T2, and T3 were 8.62%,36.84%,13.33%, and 0%, respectively. No significant difference was found among the four groups （ P≥0.05）. Among the 135 patients presenting with early glottic cancer, the anterior commissure was in-volved in 48cases, with a local recurrence rate of 25% （12/48）. In 85of the cases without anterior commissure involvement, the local recurrence rate was 10.59% （9/85）. Significant differences were found between the two groups （ P≤0.05）. Of the 133 patients who re-ceived CO2 laser surgery as the only therapy, 129 survived and 4 died. Conclusion：After laser microsurgery of early glottic carcinoma, a higher rate of tumor recurrence was found in the lesions with anterior commissure involvement. This finding needs further research.

关 键 词：激光手术 喉肿瘤 复发率 前联合 

分 类 号：R739.65[医药卫生—肿瘤]