Meyer-Breiting E, Schneider B
Laryngol Rhinol Otol (Stuttg). 1981 Feb;60(2):89-95.
61 glottic and 57 supraglottic advanced carcinomas of the larynx were investigated histologically by serial coronal sections. 29 glottic cancers spreading out more horizontally also rose from the anterior commissure. 7 supraglottic and 24 glottic carcinomas with a vertical extension to the sub- or supraglottic space involved the anterior commissure or the anterior subglottic wall secondarily. After a short introduction in the actually known principles of the anatomy of laryngeal cancer the behaviour of squamous cell carcinomas at the anterior commissure is reported. Carcinomas of the anterior commissure have a high tendency to involve the anterior subglottic wall. Tumour growth in this area is the most important condition for penetration of the laryngeal framework. Nearly all these cancers broke through the lower frontal ossified part of the thyroid cartilage without or including the cricothyroid membrane. Therefore glottic cancers with subglottic spread also preferred this direction to the prelaryngeal space. The importance of further histological findings for the technique of partial laryngectomy is discussed. More than half of the investigated carcinomas were treated by a planned preoperative irradiation of 3000 rad. By comparison with the posterior regions the frontal areas of these tumours showed microscopically a lower visible response to the radiotherapy. In our opinion this indicates that radiation failure in carcinomas of the anterior commissure is caused by the usually applied cross field radiation technique.
通过连续冠状切片对61例声门型和57例声门上型晚期喉癌进行了组织学研究。29例水平扩展更明显的声门型癌也起源于前联合。7例声门上型癌和24例垂直扩展至声门下或声门上间隙的声门型癌继发累及前联合或声门下前壁。在简要介绍喉癌解剖学的已知原理后，报告了前联合处鳞状细胞癌的行为。前联合处的癌极易累及声门下前壁。该区域的肿瘤生长是穿透喉支架的最重要条件。几乎所有这些癌症都突破了甲状软骨的下前部骨化部分，无论有无环甲膜。因此，伴有声门下扩散的声门型癌也更倾向于向喉前间隙这个方向发展。讨论了进一步的组织学发现对部分喉切除术技术的重要性。超过一半的被研究癌症接受了3000拉德的术前计划性放疗。与后部区域相比，这些肿瘤的前部区域在显微镜下对放疗的可见反应较低。我们认为，这表明前联合处癌放疗失败是由通常应用的交叉野放疗技术所致。
