T_3、T_4期声门型喉癌患者出现颈部淋巴结转移的相关因素分析  

Analysis of correlated factors of cervical lymphatic metastasis of T_3 and T_4 glottic carcinoma

作　　者：李翔宇[1] 王吉选 孙海燕[3] 胡艳红[1] 王东海[1] 赵国锋[1] 

机构地区：[1]唐山市协和医院耳鼻咽喉头颈外科,河北唐山063000 [2]华北理工大学附属医院骨科 [3]唐山职业技术学院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第17期1517-1518,1521,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析T3、T4期声门型喉癌患者颈部淋巴结转移的相关因素。方法:回顾分析91例声门型喉癌(均为鳞状细胞癌)患者的临床资料,观察患者T分期、病理分化程度及肿瘤部位对颈部淋巴结转移的影响。结果:191例T3、T4期声门型喉癌患者颈部淋巴结总转移率为21.98%;2T3、T4期患者的颈部淋巴结转移率分别为18.06%、36.84%(P>0.05);按病理分化程度分类,高、中、低分化者的颈部淋巴结转移率分别为13.89%、26.00%、40.00%(P>0.05);3肿瘤侵及声带组无转移,侵及声门及声门上组的转移率为16.22%,侵及声门及声门下组的转移率为15.38%,同时侵及声门、声门上及声门下组的转移率为46.15%(P<0.01)。结论:T3、T4期声门型喉癌患者颈淋巴结转移情况不完全受T分级及病理分化程度影响,当肿瘤侵及声门上区及声门下区后,颈淋巴结转移率明显增高,因此肿瘤的侵及范围是淋巴结转移的重要因素。Objective：To analyze the correlated factors of cervical lymphatic metastasis of T3 and T4 glottic carcinoma. Method：We did a retrospective analysis of 91 glottic carcinoma patientsr clinical data to analyze cervical lymph node metastasis on different T stage, pathologic degree and the tumor sites. Result： The cervical lymph node metastasis rate of 91 cases of T3 and T4 glottic carcinoma was 21.98%. T3 grouprs metastasis rate was 18.06%（13/72）, T4 group＇s metastasis rate was 36.84% （7/19）,P〉0.05. Grouped according to the degree of pathological differentiation, well-differentiated squamous cell carcinoma metastasis rate is 13.89%（5/36）, middle- differentiated squamous cell carcinoma metastasis rate is 26.00% （13/50）, and poorly-differentiated squamous cell carcinoma metastasis rate is 40.00 % （2/5）, P〉0.05. Cervical lymph node metastasis rate was 16.22 %, when the tumor invading supraglottic region. Cervical lymph node metastasis rate was 15.38%, when the tumor invading suhraglottic region. Cervical lymph node metastasis rate was 46.15 %, when the tumor invading supraglottic and subraglottic region （P〈0.01）. Conclusion： Cervical lymph node metastasis in cN0 patient with supraglottic carci- noma is effected by T classification, cervical lymphatic metastasis of T3 and T4 glottic carcinoma is not entirely effected by T stage and pathologic degree. When the tumor invades supraglottic and subraglottic region, cervical lymph node metastasis is significantly higher. Therefore, the area of tumor invasion is an important factor for lymph node metastasis.

关 键 词：喉肿瘤 颈淋巴结 相关因素 

分 类 号：R739.6[医药卫生—肿瘤]