颈部淋巴结处理方式对cN0声门上型喉癌患者预后的影响  

The effect of different treatment of cervical lymph node on the prognosis of patients with clinically negative neck(cN_0) supraglottic laryngeal carcinoma

作　　者：李檬[1,2] 曹华[1] 孙慧如[1] 

机构地区：[1]郑州大学第一附属医院耳鼻咽喉头颈外科,郑州450052 [2]郑州市儿童医院耳鼻咽喉科郑州,450000

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第3期113-116,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:总结颈部淋巴结的处理方式对cN0声门上型喉癌患者预后的影响,探讨cN0声门上型喉癌患者行选择性颈部Ⅱ、Ⅲ和(或)Ⅳ区淋巴结清扫的意义。方法:回顾性分析我院2003-01-2007-05确诊为cN0声门上型喉鳞状细胞癌且有完整病历资料的83例患者,原发灶均经手术切除,随访5年以上或至患者死亡。分析择区性颈部淋巴结清扫术与其他方法(放疗、综合治疗、随诊观察)处理颈部淋巴结后,患者生存率有无统计学意义。结果:cN0声门上型喉癌颈部淋巴结转移率为30.77%,且随着T分期的增加,颈淋巴结的转移率也逐渐增高。采取干预措施的患者颈部淋巴结复发率明显低于未采取干预措施者(P<0.05)。清扫组与放疗组、综合组5年生存率差异均无统计学意义(P>0.05),观察组与清扫组差异有统计学意义(P<0.05)。结论:择区性颈清扫术是临床上处理cN0声门上型喉癌患者颈部淋巴结的有效措施之一。Objective：To summarize the effect of different treatment of cervical lymph node on the prognosis oi patients with clinically negative neck （cN0） supraglottic laryngeal carcinoma （SGLC）, and to explore the signifi- cance of selective neck dissection of levels Ⅱ , Ⅲ and（or） 1Von SGLC patients with cN0 neck. Method： A retrospec- tive analysis was undertaken for 83 supraglottic laryngeal squamous cell carcinoma patients with cN0 from January 2003 to May 2007 at the Department of Otoiaryngology, First Affiliated Hospital of Zhengzhou University. All medical records was complete and all primary tumor were resected by surgery, the follow-up time was at least 5 years or until patients died. The patientsr five year survival rate was compared between the selective neck dissec- tion group and other three groups （neck radiotherapy group, combined therapy group and ＂wait and see＂ policy group）. Result：The rate of cervical lymph node metastasis of cN0 supraglottic carcinoma patients with cN0 neck was 30.77% ,and with the increasing of T stage, the rate of cervical lymph node metastasis increased gradually. The cervical lymph node recurrence rate of intervention groups was significantly lower than that of ＂wait and see＂ group （P〈0.05）. No significant difference（P〈0. 05） of 5-year survival rate between selective neck dissection group,neck radiotherapy group, combined therapy group was observed, the difference was significant between se- lective neck dissection group and observation group（P〈0.05）. Conclusion：Selective neck dissection is one of effec- tive measures to process neck lymoh node for oN0 SGLC clinically.

关 键 词：喉肿瘤 声门上型 淋巴转移 预后 

分 类 号：R739.65[医药卫生—肿瘤]