T1声门型喉鳞癌喉垂直部分切除术的手术切缘与局部复发的关系  

Relationship between Surgical Margin and Local Recurrence in Vertical Partial Laryngectomy for T1 Glottic Squamous Cell Carcinoma

作　　者：张贵[1] 范栩嫚 ZHANG Gui;FAN Xuman(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2021年第8期1289-1291,共3页The Practical Journal of Cancer

基　　金：2019年河南省医学科技攻关计划联合共建项目(编号:LHGJ20191016)。

摘　　要：目的探讨T1声门型喉鳞癌喉垂直部分切除术(VPL)的手术切缘与局部复发的关系。方法回顾性分析实施喉垂直部分切除术的68例T1声门型喉鳞癌患者一般资料,根据其术后是否复发分为2组,其中术后无复发组患者45例,术后复发组23例。对比2组患者的手术切缘、肿瘤直径和浸润深度。手术切缘包括平均手术上切缘(USMs)、平均手术下切缘(LSMs)和平均后外侧手术切缘(PLSMs)、最短切缘。肿瘤直径分为前后径、上下径、内径以及平均直径。根据其肿瘤切缘距离大小分为肿瘤切缘距离>5 mm和肿瘤切缘距离0~5 mm,不同肿瘤切缘距离中肿瘤患者的比例。结果2组患者的肿瘤平均前后径、平均上下径、平均内径及平均直径比较,差异无统计学意义(P>0.05)。在手术切缘分析中,2组患者的USMs和LSMs比较,差异无统计学意义(P>0.05);复发组PLSMs、平均最短切缘明显低于无复发组,差异具有统计学意义(P<0.05)。无复发组患者肿瘤切缘距离>5 mm的比例明显高于复发组,而肿瘤切缘距离≤5 mm患者的比例明显低于复发组,差异有统计学意义(P<0.05)。结论PLSMs、最短切缘对VPL治疗的T1声门型喉鳞癌患者的局部复发有显著影响,最短的肿瘤切缘距离应为5 mm。Objective To analyze the relationship between surgical margin and local recurrence of T1 glottic squamous cell carcinoma.Methods The general data of 68 patients with T1 glottic squamous cell carcinoma who underwent vertical partial laryngectomy were retrospectively analyzed.According to the postoperative recurrence,they were divided into two groups,45 cases in non recurrence group and 23 cases in postoperative recurrence group.The surgical margin,tumor diameter and depth of invasion were compared between the two groups.The surgical margins included the average upper surgical margins(USMs),the average lower surgical margins(LSMs),the average posterolateral surgical margins(plsms),and the shortest margins.The tumor diameter was divided into anteroposterior diameter,upper and lower diameter,inner diameter and average diameter.According to the size of the tumor margin distance,it was divided into tumor margin distance>5 mm and tumor margin distance 0-5 mm.Results There was no significant difference in the average anteroposterior diameter,average upper and lower diameter,average inner diameter and average diameter between the 2 groups(P>0.05).In the surgical margin analysis,there was no significant difference in USMs and LSMs between the 2 groups(P>0.05);plsms and the average shortest margin in the non recurrence group were significantly lower than those in the non recurrence group(P<0.05).The proportion of patients with tumor margin distance>5 mm in non recurrence group was significantly higher than that in recurrence group,while the proportion of patients in non recurrence group was significantly lower than that in recurrence group(P<0.05).Conclusion Plsms and the shortest cut edge have significant influence on the local recurrence of T1 glottic squamous cell carcinoma treated by VPL.The shortest distance of tumor margin should be 5 mm.

关 键 词：T1声门型喉鳞癌 喉垂直部分切除术 手术切缘 局部复发 关系 

分 类 号：R739.[医药卫生—肿瘤]