喉部非鳞状细胞癌的临床特征分析(附11例报告)

Clinical features of laryngeal nonsquamous cell carcinoma(A report of 11 cases)

目的探讨喉部非鳞状细胞癌的临床特点、治疗经过及疗效。方法回顾性分析1990年1月～2003年12月在本院经过病理确诊和治疗的11例喉部非鳞状细胞癌患者的临床资料。应用Kaplan-Meier法进行生存分析。结果11例喉部非鳞状细胞癌中黏液表皮样癌2例,未分化小细胞癌2例,腺泡细胞癌1例,腺癌2例,腺样囊性癌1例,滑膜肉瘤1例,恶性纤维组织细胞瘤1例,恶性淋巴瘤1例。手术治疗10例,其中单纯手术治疗5例,术后辅助放疗4例,术后辅助放疗加化疗1例;放疗加化疗1例。随访3～188个月,1、3、5年生存率分别为90.9%、51.1%、38.4%。结论喉部非鳞状细胞癌有其自身特点,颈淋巴结转移及远处转移较常见;除恶性淋巴瘤外治疗上应选择手术治疗为主,必要时辅以放疗及化疗。

Objective To summarize the clinical features,treatment and curative results of laryngeal nonsquamous cell carcinoma.Methods Clinical data of 11 patients with pathologically confirmed primary laryngeal nonsquamous malignancies treated in our department from Jan.1990 to Dec.2004 was analyzed retrospectively.Survival analysis was performed with Kaplan-Meier method.Results The laryngeal nonsquamous malignancies of the 11 cases included mucoepidermoid carcinoma（2 cases）,undifferentiated small cell carcinoma（2 cases）,acinic cell carcinoma（1 case）,adenocarcinoma（2 cases）,adenoid cystic carcinoma（1 case）,synovial sarcoma（1 case）,malignant fibrous histiocytoma（1 case）and malignant lymphoma（1 case）.Of all the 11 cases,10 underwent surgical treatment（5 patients received surgery only,4 received surgery plus postoperative radiotherapy,1 received surgery plus radio-chemotherapy）,1 received radiotherapy plus chemotherapy.All the cases were followed up 3 to 188 months.The 1-,3-and 5-year survival rates were 90.9%,51.1% and 38.4% respectively.Conclusion Nonsquamous malignancies of the larynx have their own biological characteristics;lymphatic and distant metastases are relatively common.Surgical resection is the major treatment strategy（excluding malignant lymphoma）with postoperative radiotherapy or chemotherapy when necessary.