病理分化程度对声门上型喉癌颈清扫的影响

Influence of Pathological Differentiation Degree on Neck Dissection of Supraglottic Laryngeal Carcinoma

目的分析不同分化程度的声门上型喉鳞状细胞癌(SLSCC)的颈淋巴结转移(LNM)规律。方法回顾性分析2015年1月—2019年12月于重庆医科大学附属第一医院病理诊断为SLSCC的患者不同病理分化程度LNM的差异。结果共纳入79例患者,其中低分化组20例、中分化组52例和高分化组7例;N038例,N18例,N228例,N35例;36例出现Ⅱ区LNM,21例出现Ⅲ区LNM,7例出现Ⅳ区LNM,Ⅴ区和Ⅵ区未发现LNM。结论SLSCC患者能从双侧颈清扫术中获益,低、中分化患者能从清扫双侧Ⅱ-Ⅳ区中获益,高分化患者清扫双侧Ⅱ-Ⅲ区可能更合适。

Objective To analyze the patterns of lymph nodes metastasis(LNM)in supraglottic laryngeal squamous cell carcinomas(SLSCC)patients with different tumor differentiation.Methods We retrospectively investigated the clinicopathological data of patients diagnosed as SLSCC.The LNM patterns were analyzed by different tumor differentiation degrees.Results A total of 79 patients were included and divided into poorly differentiated group(n=20),middle differentiated group(n=52)and well differentiated group(n=7).There were 38 patients in N0 stage,8 patients in N1 stage,28 patients in N2 stage and 5 patients in N3 stage;36 patients with LNM in levelⅡ,21 patients with LNM in levelⅢ,7 patients with LNM in levelⅣand no patients with LNM in levelⅤorⅥ.Conclusion SLSCC patients can benefit from bilateral neck dissection,and the patients with poor or moderate differentiation can benefit from neck dissection(levelsⅡ-Ⅳ),while the patients with well differentiation dissection may be more appropriate for neck dissection(levelsⅡ-Ⅲ).