原发性喉肿瘤的定位、大小、分期及组织病理学与颈部转移的关系。
The Relationship between the Localization, Size, Stage and Histopathology of the Primary Laryngeal Tumor with Neck Metastasis.
作者信息
Mutlu Vahit, Ucuncu Harun, Altas Enver, Aktan Bulent
机构信息
Department of Otolaryngology, Erzurum Education and Research Hospital, Erzurum, Turkey.
Department of Otolaryngology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
出版信息
Eurasian J Med. 2014 Feb;46(1):1-7. doi: 10.5152/eajm.2014.01.
OBJECTIVE
In this study we aimed the investigate the laryngectomy (partial and total) and neck dissection (functional, radical) in patients undergoing larynx identified as a result of the operation of primary tumour localization, size, stage and histopathology of the relationship between neck metastasis.
MATERIALS AND METHODS
The files of 118 patients who has had operation of laryngectomy (partly, total) and neck dissection (functional, radical) because of larynx cancer in the Ear Nose and Throat (ENT) Clinic in the last ten years (1997-2007) have been evaluated retrospectively.
RESULTS
116 of them were male and 2 of them were female. Age average was 56+/-22. 189 neck dissections have been applied to 118 patients. While in supraglottic tumours, 55.2% cervical metastasis and 28.9% occult metastasis have been determined, in transglottic tumours 35.1% cervical metastasis and 18.9% occult metastasis have been determined. It has been seen that while the cervical metastasis ratio of tumours bigger than 4 cm is 55.8%, the tumours smaller than 4 cm is 27.27% (p=0.002). The cervical metastasis rate has been determined as 26.3% in T1 cases, 25.8% in T2 cases, 40.6% in T3 cases and 58.3% in T4 cases. In tumours with advanced T stage, the rate of cervical metastasis has been seen more than the ones with early T stage (p=0.027). Cervical metastasis has been determined as 27.3% in good differential (G1) tumours, 53.4% in medium differential (G2) tumours, and 74.1% in bad differential (G3) tumours (p=0.005).
CONCLUSION
Considered in the light of clinical parameters specified in the cervical lymph node metastasis, N0 patients with laryngeal cancer, tumour, according to the anatomical location as unilateral or bilateral elective neck dissection should be performed and histopathological specimens taken in the event of a positive detection of metastases concluded that postoperative radiotherapy should be performed.
目的
在本研究中，我们旨在调查因原发性肿瘤的定位、大小、分期以及组织病理学与颈部转移之间的关系而接受喉切除术（部分和全喉）和颈部清扫术（功能性、根治性）的患者情况。
材料与方法
回顾性评估了过去十年（1997 - 2007年）在耳鼻喉科诊所因喉癌接受喉切除术（部分、全喉）和颈部清扫术（功能性、根治性）的118例患者的病历。
结果
其中116例为男性，2例为女性。平均年龄为56±22岁。对118例患者进行了189次颈部清扫术。声门上型肿瘤中，确定有55.2%的颈部转移和28.9%的隐匿性转移；声门型肿瘤中，确定有35.1%的颈部转移和18.9%的隐匿性转移。可见，肿瘤大于4 cm时颈部转移率为55.8%，肿瘤小于4 cm时为27.27%（p = 0.002）。T1期病例颈部转移率为26.3%，T2期为25.8%，T3期为40.6%，T4期为58.3%。在T分期较晚的肿瘤中，颈部转移率高于T分期较早的肿瘤（p = 0.027）。高分化（G1）肿瘤颈部转移率为27.3%，中分化（G2）肿瘤为53.4%，低分化（G3）肿瘤为74.1%（p = 0.005）。
结论
根据颈部淋巴结转移的临床参数，对于喉癌N0患者，应根据肿瘤的解剖位置进行单侧或双侧选择性颈部清扫术，若转移检测呈阳性则取组织病理学标本，并得出结论认为术后应进行放疗。
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