早期声门型喉癌CO_2激光术后复发相关因素分析

Evaluate the related factors of recurrence after carbon dioxide laser in treatment of early glottic carcinoma

目的:分析CO2激光治疗早期声门型喉癌患者术后复发的相关因素。方法:回顾性分析134例超脉冲CO2激光治疗的早期声门型喉癌患者的临床资料,观察其复发与性别、年龄、病理分化程度、T分期、前联合受侵情况及甲杓肌受侵情况的关系。结果:高分化鳞状细胞癌复发率为11.83%,中分化鳞状细胞癌为18.42%,低分化鳞状细胞癌为33.33%,差异无统计学意义(P>0.05);T1a复发率为13.24%,T1b复发率为18.92%,T2复发率为23.08%,差异无统计学意义(P>0.05);前联合受侵者术后复发率为33.33%,未受侵者术后复发率为5.43%,差异有统计学意义(P<0.01);甲杓肌受侵者术后复发率为59.09%,未受侵者术后复发率为5.36%,差异有统计学意义(P<0.01)。单因素和多因素分析显示前联合及甲杓肌受侵是复发的相关因素。结论:前联合及甲杓肌受侵者术后复发率明显增高;肿瘤的切除应根据肿瘤的范围和深度,分别施行不同类型的切除。

Objective：To analyze the recurrencerelative factors of early glottic carcinoma after carbon dioxide laser treatment.Method：A retrospective analysis of 134 early glottic carcinoma patients′clinical data was taken to analyze the relationships between recurrence and gender,age,pathologic degree,T stage,involvement of anterior commissure and involvement of thyroarytenoid muscle.Result：Recurrent ratio of well-differentiated,middle-differentiated and poorly-differentiated squamous cell carcinoma were 11.83%,18.42%and 33.33%（P〉0.05）respectively.Recurrent ratio of T1 a,T1b,T2 were 13.24%,18.92%,23.08%（P〉0.05）respectively.The recurrent rate was 33.33%of tumors offended the anterior commissure,versus 5.43% with no involvement of anterior commissure（P〈0.01）.The recurrent rate was 59.09%of tumors offended the thyroarytenoid muscle,versus 5.36%with no involvement of thyroarytenoid muscle（P〈0.01）.Unvaried and multivariate analysis indicated that the involvement of anterior commissure and the involvement of thyroarytenoid muscle were the factors of recurrence.Conclusion：Recurrence of early glottic carcinoma after carbon dioxide laser treatment is effected by the involvement of anterior commissure and the involvement of thyroarytenoid muscle.Resection can be performed conservatively according to evaluation of macroscopic tumour extension.