摘要
目的探讨喉室癌的定义、临床特征、预后因素与治疗方式。方法回顾性分析27例原发于喉室的喉癌患者的临床资料,分析不同T、N级喉室癌以及经不同方式治疗的喉室癌患者的3年无瘤生存率。结果原发于喉室的肿瘤从喉室向四周生长而使室带表面正常黏膜隆起,27例喉室癌患者中T1、T2、T3、T4级患者分别为0、3、24、0例;8例术前病理报告未能确诊喉癌;3例T2级患者中,术前有2例诊断为T1病变,24例T3级患者中,术前7例诊断为T2病变;本组病例中,颈淋巴结转移率为40.7%(11/27),其中,T2、T3级患者颈淋巴结转移率分别为33.3%(1/3)、41.7%(10/24);本组患者的3年无瘤生存率为63.0%(17/27),T2、T3级患者3年无瘤生存率分别为66.7%(2/3)、62.5%(15/24);N0、N1与N2患者的生存率分别为75%(12/16)、50%(3/6)与40%(2/5);行喉全切除术、喉近全切除术、喉水平垂直部分切除术与喉扩大垂直部分切除术的患者的生存率分别为66.7%(8/12)、50%(1/2)、80%(4/5)与50%(4/8)。结论喉室癌是一种特殊的声门上型喉癌,不易早期诊断,术前易低估肿瘤局部浸润范围;根据肿瘤局部浸润范围,T2、T3级喉室癌患者可以行喉部分切除术;喉室癌患者颈淋巴结转移率高,N0患者手术时应同时行分区性颈淋巴结清扫术。
OBJECTIVE To study the definition of laryngeal ventricle carcinoma, and its clinical characteristics, prognostic factors and therapeutic modalities. METHODS Twenty-seven cases with laryngeal ventricle carcinoma were retrospectively reviewed, 3-years disease free survival of the patients were analyzed according to the different T, N stages and the therapeutic modalities. RESULTS Laryngeal ventricle carcinoma originated in laryngeal ventricle mucosa, from where tumor invaded surrounding tissue latently. Twenty-seven cases were consisted of 3 cases in T2 and 24 cases in T3. Eight of 27 cases with laryngeal ventricle carcinoma were not diagnosed by preoperative biopsy. Preoperatively, 2 of 3 cases with T2 laryngeal ventricle carcinoma were misdiagnosed as T1 stage, 7 of 24 cases with T3 laryngeal ventricle carcinoma were misdiagnosed as T2 stage. The 40.7 percent （11/27） cases were confirmed with cervical lymph nodes metastases. The 3 years disease free survival was 63.0% （17/27） in all cases and was 66.7% （2/3） , 62.5% （15/24） in T2, T3 stage respectively. The survival rates of the cases with N0, N1, N2 were 75.0%, 3/6, 2/5 respectively. The survival rates of the patients were 66.7% （8/12） , 50% （1/2） , 80% （4/5） , 50% （4/8） respectively in total laryngectomy, near total laryngectomy, horizontovertical partial laryngectomy and extended vertical partial laryngectomy. CONCLUSOIN Laryngeal ventricle carcinoma is a special suppraglottic carcinoma, which is not easy to be diagnosed early, and the local infiltration of the tumor is often underestimated preoperatively. Partial laryngectomy is an available therapeutic method for T2-3 laryngeal ventricle carcinoma. Due to higher rate of cervical lymph nodes metastasis in the cases with laryngeal ventricle carcinoma, selective neck dissection should be performed simultaneously in the cases with N0.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2009年第5期230-232,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
喉肿瘤
癌
鳞状细胞
声门
喉室
Laryngeal Neoplasm
Carcinoma
Squamous Cell
Glottis
laryngeal ventricle
