支撑喉镜下CO_2激光治疗声门型喉癌术后白膜与早期复发临床分析

Observation the albuginea and earlier neoplasm recurrence of laryngeal carcinoma treated by suspension laryngoscope laser technique

目的了解支撑喉镜下CO2激光治疗早期声门型喉癌术后白膜与早期复发的临床特点。方法随访2008年9月～2010年11月我院支撑喉镜下CO2激光治疗早期声门型喉癌32例,术后患者行纤维喉镜检查,对可疑患者行活检。对术后喉癌复发以及术后白膜患者进行分析。结果 32例早期声门型喉癌;喉鳞状细胞癌31例,喉腺样囊性癌1例,Tis病变5例,T1aN0M0病变13例,T1bN0M0病变9例,T2N0M0病变5例,T1aN0M0病变1例在术后4个月复发。T1bN0M0病变及T2N0M0病变各1例在术后3个月复发,喉腺样囊性癌T2N0M0病变1例在术后5个月复发,总复发率为12.5%;T1aN0M0病变复发率7.69%(1/13),T1bN0M0病变复发率11.11%(1/9),T2 N0M0病变复发率40%(2/5),所有患者术后白膜期可持续2～3个月。结论支撑喉镜下CO2激光治疗早期声门型喉癌术后,早期复发时间多在半年内。早期复发与术后白膜容易混淆,术后3个月仍然有白膜病变要高度重视复发可能。

Objective To understand the clinical feature of the albuginea and earlier neoplasm recurrence of laryngeal carcinoma treated by suspension laryngoscope laser technique. Methods From september 2008 to november 2011, retrospective analysis of 32 cases of early glottic laryngeal carcinoma treated with laser surgery were carried out. To research the albuginea and neoplasm recurrence by fibrolaryngoscope and biopsy. Results Among these cases, laryngeal squamous carcinoma were 31 cases and laryngeal adenoid cystic carcinoma was 1 case. Tis were 5 cases; TlaNOM0 were 13 cases; TlbNOM0 were 9 cases;T2NOM0 were 5 cases. Relapse were detected in 4 out of 32 cases of glottic laryngeal carcinoma after CO2 laser surgery. The recurrent rate was 12. 5 % （4/32）. Recurrent ratio of T1 a was 7. 69 % （ 1/13 ） in 4 months after operation ; T1 b was 11.11% （ 1/9） in 3 months after operatian; T2 were 40% （2/5） in 3 months and 5 months after operation. Albuginea in all postoperative cases last 2 to 3 months. Conclusion To distinguish tile albuginea and earlier neoplasm recurrence of laryngeal carcinoma treated by suspension layngoscope laser technique is difficult. Relapse often takes place in 6 months after operation. To attach importance to distinguish postoperative albuginea and earlier neoplasm recurrence in 3 months after operation.