CO_2激光微创手术治疗早期喉癌

Carbon dioxide laser microsurgery for early glottic carcinoma

目的观察CO2激光微创手术治疗早期喉癌的安全性、远期疗效。方法回顾性分析1999年10月至2007年5月接受CO2激光显微外科手术治疗91例声门型喉癌(Tis 9例,pT1a 45例,pT1b 25例,和pT2 12例),对其中20例患者术后创面前、后、中上、中下及深部切缘组织同时进行常规病理切片镜检及PCNA免疫组织化学测定。结果依照Kaplan-Meier方法计算5年整体生存率为92.72%,无瘤生存率84.62%。采用3 mm安全界100个切缘标本中,发现癌细胞残留3个(2名患者)。结论早期喉癌CO2激光微创手术,不仅损伤小,愈合快,而且远期疗效好,采用3 mm安全界可获得安全切缘。

Objective To investigate the oncologic efficacy and safety of transoral endoscopic CO2 laser surgery in early glottic carcinoma. Methods A retrospective study of 91 patients with glottic carcinoma （9 Tis, 45 pTla, 25 pTlb, and 12 pT2） treated from October 1999 to May 2007. The clinicopathology and the PCNA expression in 100 tissue＇ s specimen of 20 postoperative patients was studied. Results According to the Kaplan-Meier method, the 5 year overall survival and the diseaseffee survival were 92.72% and 84.62% respectively. Among 100 specimen, tumor cell were detected in there specimen of two patients. Conclusions According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer. The resection margin of there millimeters to tumor＇s borderline is security.