声门型喉癌颈淋巴结转移相关因素的研究

Preliminary study on the correlation factors of cervical lymphatic metastasis of glottic carcinoma

目的 总结声门型喉癌颈淋巴结转移发生率 ,探讨影响声门型喉癌颈淋巴结转移的相关因素。方法 对 1983年 1月～ 1999年 5月年间中国医科大学第一临床学院耳鼻咽喉科收治的452例声门型喉癌进行回顾性分析。男女比例约为 10∶1,年龄 42～ 79岁之间 ,平均 59 3岁。结果声门型喉癌颈淋巴结转移发生率为 3 54% (16/ 4 52例 ) ,其中早期 (T1和T2期 )声门型癌颈淋巴结转移发生率为 0 2 9% (1/ 3 4 0例 ) ,晚期 (T3和T4期 )颈淋巴结转移发生率为 13 3 9% (15/ 112例 )。所有转移淋巴结均位于肿瘤病变侧Ⅱ、Ⅲ及Ⅳ区。结论 声门型喉癌肿瘤组织对声门下、室带等处侵及率相近 ,肿瘤累及上述不同部位其颈淋巴结转移的发生率差异无显著性。对于临床诊断无颈部淋巴结转移的声门型喉癌患者 ,不需要行颈清扫术。

Objective To investigate the incidence of occult nodal in glottic carcinoma and access the correlations between the cervical lymph nodes metastases and originals of tumor Methods A retrospective review was made on 452 patients from January 1983 to May 1998 413 patients were male and 39 were female The age ranged from 42 to 79 years with a mean of 59 3 years Results The incidence of occult nodal in glottic carcinoma was low (3 54%), and 0 29% in early stage (T1-T2), 13 39% in late stage (T3-T4), respectively The number of metastasis lymph nodes was 7 in level Ⅱ(43 75%), 7 in level Ⅲ(43 75%) and 2 in level Ⅳ(12 5%) Conclusion According to the multivariate analysis, none of the factors such as histopathologic differentiation and invasion of peripheral tissue significantly affect on cervical metastases The incidence of cervical lymph nodes metastases in glottic carcinoma is low Selective neck resection should not be undertaken even for the advanced stage that don′t exist metastases