侵及气道和消化道的晚期甲状腺癌的外科治疗  

Surgical treatment of advanced thyroid carcinoma with aero-digestive invasion

作　　者：葛俊恒[1] 赵瑞利[1] 胡俊兰[1] 周维安[1] 

机构地区：[1]河北医科大学第四医院耳鼻咽喉科,石家庄050011

出　　处：《中华耳鼻咽喉科杂志》2004年第4期237-240,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　探讨侵及气道和消化道的晚期甲状腺癌的外科治疗方法。方法　回顾性分析了1988～ 1998年经治的 18例晚期甲状腺癌患者 ,均有气道、消化道的侵犯。结果　晚期甲状腺癌侵及气道、消化道的发病率占全部甲状腺癌的 3 5 % (18/ 5 16 ) ,腔内受侵率为 2 7% (14 / 5 16 )。其中 ,仅 1个器官受累 10例 ,占 5 5 6 % (10 / 18) ,其中最常见的是气管 ;其他依次是食管、喉、喉咽 ;2个及 2个以上器官受累 8例 ,占 4 4 4 % (8/ 18)。生存 1、3、5和 10年者分别为 17、14、9和 6例。分化型甲状腺癌的 5年生存率 (6 1 5 % )明显高于未分化癌 (2 0 0 % ) ,但统计学处理差异没有显著性意义 (P >0 0 5 ) ,其远期生存率与肿瘤的分期差异也无显著性意义 (P >0 0 5 ) ,这可能与临床例数太少有关。结论　侵犯气道消化道的晚期甲状腺癌需要广泛切除受侵的部分 ,选用有效的手术方式 ,同时给予辅助治疗 。Objective To study the surgical management of the advanced thyroid carcinoma with aero digestive invasion Methods To analyze 18 cases of advanced thyroid carcinoma which had aero digestive invasion retrospectively ,the patients were treated from 1988 to 1998 Results The rate of aero digestive invasion occur was 3 5%(18/516), The inner cavity invaded rate was 2 7%(14/516) The most invaded organ was trachea; The others were esophagus and larynx、pharynx ;Two and/or more organs invaded rates were 44 4%(8/18) The cases that survived 1,3,5 and 10 year were17,14,9 and 6 The 5 years survival rates of the differentiated thyroid cancer(61 5%) were more higher than the undifferentiated thyroid cancer (20 0%), but there were no statistical difference between them ( P >0 05) and the same in clinical stage( P >0 05) Conclusions Intraluminal extension is a more serious problem in which usually extensive resection of the aerodigestive tract is required Effective surgical treatment combined with postoperative auxiliary management for this kind of patients may achieve a good long term results

关 键 词：气道侵及 消化道侵及 晚期甲状腺癌 外科治疗 手术方法 

分 类 号：R736.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]