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[喉次全切除术标本的组织病理学评估]

[Histopathological evaluation of the subtotal laryngectomy specimen].

作者信息

García-Sánchez Manuel, Romero-Durán Elizabeth, Mantilla-Morales Alejandra, Gallegos-Hernández José Francisco

机构信息

Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social, México D.F., México.

Departamento de Patología, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.

出版信息

Cir Cir. 2015 Nov-Dec;83(6):537-42. doi: 10.1016/j.circir.2015.05.038. Epub 2015 Jul 7.

Abstract

INTRODUCTION

The goal of conservative surgical treatment of laryngeal cancer is to obtain oncological control with preservation of laryngeal function. The concept of laryngeal function preservation should be understood as the preservation of the patient's ability to breathe normally with neither tracheostomy nor aspiration, and maintaining intelligible speech. This can be achieved by a balance between two fundamental aspects, proper patient selection (based on tumour extension and preoperative laryngeal function), and an adequate histopathological analysis of the surgical specimen. Supracricoid subtotal laryngectomy is the voice conservative surgical technique that offers the best possibility of control in patients with locally advanced laryngeal cancer. The proper histopathological analysis allows staging and selecting patients for adjuvant therapy, avoiding unnecessary ones as well as designing monitoring and surveillance programs based on risk factors.

OBJECTIVE

To highlight key points in the histopathological evaluation of the surgical specimen of a subtotal laryngectomy.

CONCLUSION

The proper communication between the surgeon and pathologist, offering complete information on preoperative clinical evaluation and the knowledge of the key points in the evaluation of the surgical specimen (sites of tumour leakage and surgical resection margins) are fundamental parameters to achieve a proper histopathological evaluation of the surgical specimen.

摘要

引言

喉癌保守手术治疗的目标是在保留喉功能的同时实现肿瘤控制。喉功能保留的概念应理解为患者能够正常呼吸,无需气管切开术且无呛咳,并保持可理解的语音。这可以通过两个基本方面的平衡来实现,即恰当的患者选择(基于肿瘤范围和术前喉功能)以及对手术标本进行充分的组织病理学分析。环状软骨上喉次全切除术是一种保留嗓音的手术技术,为局部晚期喉癌患者提供了最佳的肿瘤控制可能性。恰当的组织病理学分析有助于对患者进行分期并选择辅助治疗方案,避免不必要的治疗,同时基于风险因素设计监测和随访计划。

目的

强调喉次全切除手术标本组织病理学评估中的要点。

结论

外科医生与病理学家之间的恰当沟通,提供术前临床评估的完整信息以及了解手术标本评估中的要点(肿瘤切缘和手术切除边缘部位),是实现手术标本恰当组织病理学评估的基本参数。

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