喉癌临床分型和分期方法的评估

Evaluation of clinical classification and TNM staging laryngeal cancer

根据美国癌症联合委员会(AJCC)和国际抗癌联盟(UICC)的TNM分期方法,喉癌分为声门上癌、声门癌和声门下癌3种临床类型,但它不能完善地包括跨声门癌(transglottic carcinoma),因为后者不符合国际癌症分期的规则。跨声门癌原发于喉室,具有早期向声门旁间隙(paraglottic space,PGS)浸润的特点,其临床特征是PGS的广泛浸润,破坏甲状软骨和颈淋巴结转移。跨声门癌常侵犯2个以上解剖区域,无T1期。作者提出4种类型的喉癌临床分型方法:声门上癌、声门癌、声门下癌、声门旁癌。本文提供了声门旁癌分期方法的详细草案。笔者学识不足,时间有限,首次向同道们探讨此难题,有待今后在长期临床实践中证实和进一步研讨。(中国眼耳鼻喉科杂志,2012,12:415-416,418)

According to Amerieatl Joint Committee on Cancer（ AJCC ） and Union for International Cancer Cuntrol （ UICC ）TN M staging system, the laryngeal cancer can be classified into 3 clinical types： supraglottic carcinoma, glottie （.arcinoma and sut）glottir t＇arcinoma, but are always not considered the transglottie carcinoma. It is because the lransglotti~： carei,oma is really nol tollowed the ndes of international cancer staging system. Transgloltic carcinoma is the laryngeal cancer originated from the ventricle with early extending inlo the paraglottic space （PGS）. Clinical t.haracterisli~.s ~f this careinolua are extensive PGS invasion, thyroid cartilage distruetion and cervical lymph node metaslasis. Transgloltie ~＇areinoma usually showed more than two anatomical region lesions and no TI eases. The author introduce a kind of ~＇lassifieation of laryngeal carcinoma with 4 clinical types ： supraglottie carcinoma, glottic ~.arcinoma, subgloltie carcinoma and paragl~/lic carcinoma. This paper also provide the details of paraglottic carcinoma staging. ＇Fo my knowledge, this study is th~, first time In explore how paraglottic carcinoma used in laryngeal cancer staging. It is difficult to prove this suggestion in limitted time, and furlher investigation is needed.