声门上型喉癌局部浸润与淋巴结转移的关系

Relationship between the local invasion and the lymph node metastasis of the supraglottic carcinoma

目的:探讨声门上型喉癌局部浸润与淋巴结转移的关系。方法:66例声门上型喉癌喉切除标本,经火棉胶包埋,制成连续切片,苏木精-伊红染色,光学显微镜下观察。结果:有淋巴结转移的声门上喉癌对会厌前间隙,声门旁间隙上、下区的侵犯率分别为100.0%(18/18)、83.3%(15/18)、44.4%(8/18),均高于无淋巴结转移声门上型喉癌,两者差异有统计学意义(P<0.05);有淋巴结转移声门上喉癌会厌前间隙全部受累率为55.5%(10/18),与无淋巴结转移喉癌29.1%(14/48)相比差异有统计学意义(P<0.05)。淋巴结转移喉癌侵犯声门旁间隙上区的宽度及高度分别为(7.4±5.2)mm,(11.6±7.6)mm,侵犯声门旁间隙下区的宽度及高度分别为(2.9±3.8)mm,(2.4±3.7)mm,这两者均大于无淋巴结转移组喉癌,差异有统计学意义(P<0.05);淋巴结转移组声门上型喉癌声带活动良好、声带固定率分别为11.1%(2/18),44.4%(8/18),与无淋巴结转移喉癌相比,差异有统计学意义(P<0.05)。结论:有淋巴结转移的声门上型喉癌具有较强的局部侵袭能力,对会厌前间隙及声门旁间隙的侵犯是其重要特征。

Objective： To explore the histopathology characteristics of supraglottic carcinoma with cervical lymph node metastasis. Method：Sixty-six specimens from patients with supraglottic laryngeal carcinoma were imbedded in collodion, made whole-organ serial section for HE staining, and observed under light microscope. Result ： The rate of supraglottic carcinoma with lymph node metastasis invasion to pre-epiglottic space, supraparaglottic space and infraparaglottic space was 100.0% （18/18）, 83.3% （15/18） and 44.4%（8/18） respectively, all of which were higher than that of supraglottic carcinoma with no lymph node metastasis （P〈0.05）. The rate of supraglottic carcinoma with lymph node metastasis invasion to the whole pre-epiglottic space was 55.5% （10/18）, and it was 29.1% （14/48） in supraglottic carcinoma without lymph node metastasis; there were significant differences between them （P〈0.05）. The width and height of supraglottic carcinoma with lymph node metastasis invasion to supraparaglottic space was （7.4±5.2）mm, （11.6±7.6）mm, respectively; The width and height of the supraglottic carcinoma invasion to infraparaglottic space was （2.9±3.8）mm, （2.2±3.7）mm, respectively. Both of them were larger than that in supraglottic carcinoma with no lymph node metastasis （P〈0.05）. For the supraglottic carcinoma with lymph node metastasis, the rate of the vocal cord fixation was 44.4% （8/18）, which was significantly higher than that of supraglottic carcinoma without lymph node metastasis （P〈0.05）. Conclusion： The supraglottic carcinoma with lymph node metastasis has special local invasion ability, and its important characteristics is the invasion to pre-epiglottic space and paraglottic space.