CO_2激光切除累及前联合的早期声门癌26例

A clinical analysis of CO_2 laser microsurgery for early glottic laryngeal carcinoma with anterior commissure involvement

目的探讨CO_2激光切除侵犯前联合的早期声门癌的临床安全性及疗效。方法回顾性分析26例行CO_2激光治疗的侵犯前联合的早期声门型喉癌患者临床资料,肿瘤标本术中冰冻、术后HE染色行镜下切缘观察,术后严格随访观察局部复发情况。结果切缘阴性20例,阳性6例,随访3年中局部复发7例,复发率为26.9%(7/26),其中切缘阳性复发率为83.3%(5/6),切缘阴性复发率为10%(2/20),组间差异有统计学意义(P=0.002)。结论 CO_2激光治疗累及前联合的早期声门型喉癌喉功能保全良好,疗效可靠,但需严格把握手术适应证以确保切缘安全,降低局部复发率。

Objective To explore the clinical safety and curative effect of CO2 laser microsurgery in the treatment of early glottis carcinoma with anterior commissure involvement.Methods Clinical data of 26 cases of early glottic laryn-geal carcinoma with anterior commissure involvement treated with CO2 laser microsurgery were retrospectively ana-lyzed.Surgical specimens were conventionally embedded with paraffin and serially sectioned,and then stained using hematoxylin-eosin for pathologic examination.All patients were closely followed up to observe the local recurrence rate.Results Of all 26 surgical margins,20 were negative and 6 were positive.Relapse was detected in 7 cases,the recurrence rate being 26.9% （7 /26）.The recurrence rate of positive and negative surgical margins was 83.3% （5 /6） and 10% （2 /20）,respectively,with statistical differences （P =0.002）.Conclusion CO2 laser microsurgery can safely and effectively preserve the vocal function of early stage glottis carcinoma with anterior commissure involvement. However,the operation indications should be strictly followed in order to guarantee safe surgical excision and reduce local recurrent rate.