喉癌喉部分切除术切缘状况与患者预后的相关性研究

Prognosis and surgical margin of the partial laryngectomy

目的回顾性研究喉鳞状细胞癌患者喉部分切除术后切缘状况与患者预后的相关性。方法回顾性研究2001年8月～2006年9月135例喉部分切除术患者的情况,所有切缘标本行常规病理检查,局部复发及淋巴结转移率与切缘情况进行相关性研究。结果 26例阳性切缘中,9例不典型增生,17例切缘有癌细胞浸润,其余109例切缘常规病理阴性。对患者随访3年发现135例中17例局部复发,其中10例来自切缘阳性患者,7例来自阴性切缘患者。无局部复发患者3年生存率明显高于局部复发者。结论阳性切缘患者导致局部复发或淋巴结转移率明显高于阴性切缘患者,术后切缘的病理检查为阳性切缘患者随后的治疗起指导作用。

OBJECTIVE To assess the prognostic value of surgical margin involvement in patients with squamous cell carcinoma of the larynx.METHODS The clinical data of 135 patients treated with partial laryngectomy from 2001.8 to 2006.9 were retrospectively studied.A histopathological study on the surgical margins was performed in all cases.The incidence of local recurrence and the histological features of resection margins were evaluated.RESULTS Twenty-six patients（19.3%）were identified as having positive margins：17 had invasive carcinoma and 9 had dysplastic lesions.The remaining 109 patients（80.7%）had negative margins.Subsequent follow-up showed that 13 of 135 patients developed local recurrence and 4 patients developed regional recurrence.Ten of these patients had positive resection margins（8 with invasive carcinoma and 2 with dysplastic lesions）,and 7 had negative resection margins.Overall 3-year survival rate was significantly higher for patients without recurrence than patients with local or regional failure（87.4% and 12.6%,P0.05）.CONCLUSION According to the results of the study,patients with positive resection margins developed local recurrence more frequently than those with negative resection margins（P0.05）.The pathological examination of resection margins is an important ways for subsequent treatment of patients with positive margins.