Service ORL et chirurgie cervicofaciale, hôpital Bretonneau, CHRU de Tours, boulevard Tonnellé, Tours, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2012 Feb;129(1):1-5. doi: 10.1016/j.anorl.2011.04.002. Epub 2011 Jul 27.
The authors studied the prevalence of histological thyroid gland invasion in laryngopharyngeal cancer and the preoperative endoscopic and CT signs predictive of this invasion.
Retrospective study of patients with laryngopharyngeal squamous cell carcinoma (T3 and T4) treated by total laryngectomy or total laryngopharyngectomy associated with concomitant total thyroidectomy or ipsilateral lobectomy and isthmectomy.
Eighty-seven patients were included. Eleven patients (12.6%) presented thyroid gland invasion. Subglottic tumour extension greater than or equal to 10mm (P=0.008) and cricoid cartilage destruction on CT (P=0.001) were statistically correlated with histological thyroid gland invasion. An intact appearance of the laryngeal cartilages on CT was associated with a low probability of thyroid gland invasion.
Thyroid gland invasion must not be underestimated in patients with advanced laryngopharyngeal cancer. Preoperative CT is an essential part of the preoperative work-up. Thyroidectomy must not be performed systematically.
作者研究了喉咽癌中甲状腺组织侵袭的发生率，以及术前内镜和 CT 征象对此侵袭的预测价值。
回顾性分析了接受全喉切除术或全喉咽切除术联合同侧甲状腺全切除术或叶切除术和峡部切除术治疗的声门上型鳞状细胞癌（T3 和 T4 期）患者。
共纳入 87 例患者。11 例（12.6%）患者存在甲状腺侵袭。CT 上声门下肿瘤延伸大于或等于 10mm（P=0.008）和环状软骨破坏（P=0.001）与组织学甲状腺侵袭呈统计学相关。CT 上喉软骨完整外观与甲状腺侵袭的低概率相关。
在晚期喉咽癌患者中，甲状腺侵袭不容忽视。术前 CT 是术前评估的重要组成部分。不能系统地进行甲状腺切除术。
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