喉癌喉部分切除术的术后分析

Clinical retrospective analysis of treating laryngeal cancer by partial laryngectomy

目的 :分析喉癌喉部分切除术后复发的原因。方法 :回顾分析 77例喉癌喉部分切除的治疗效果 ,并用免疫组化的方法分析 16例部分喉切除术后肿瘤切缘组织 PCNA表达和肿瘤复发的关系。结果 :在 77例部分喉切除病例中 ,垂直部分喉切除 4 6例 ,声门上部分喉切除 17例 ,喉大部切除 9例 ,喉中段切除 5例。 13例在术后 2周拔管 ,4 1例 1个月拔管 ,11例 3个月拔管 ,1例 6个月拔管 ,11例未能拔管。 3年、5年生存率分别为 94 %、81%。共 9例复发 ,其中 3例做了全喉切除术。 6例复发病例中 ,PCNA阳性 3例 ,10例未复发病例中阳性 3例。结论 :如适应证掌握恰当 ,肿瘤切除足够 ,部分喉切除治疗喉癌是安全有效的。肿瘤切缘保留组织中 PCNA阳性与肿瘤复发有一定关系。

Objective: To analyse the cause of recurrence of laryngeal cancer after partial laryngectomy. Methods: 77patients who underwent partial laryngectomy were analysed and ABC method of immunohistochemical method was used to test 16 samples from cutting edge of laryngeal cancer with partial laryngectomy. Results: Among the 77 cases of partial laryngectomy 46 vertical laryngectomy, 17 superaglottic laryngectomy ,9 horizontovertical laryngectomy,5 horizontal glottic laryngectomy. 13 cases were extubated two weeks after operation, 41 cases extubated in a month, 11 cases extubated 3 month and 11 cases could not be extubated after operation. 3-year-survival rate was 94%, 5-year-survival rate was 81%. There were 9 cases recurred (17%), 3 of them were total laryngectomy. Conclusion: If suitable cases are selected, treatment of laryngeal cancer by partial laryngectomy shoud be effective. The positive result of PCNA in the tissue of cutting edge can be relevant to cancer recur .