Werner J A, Schünke M, Lippert B M, Koeleman-Schmidt H, Gottschlich S, Tillmann B
Klinik für HNO-Heilkunde, Universität Kiel.
HNO. 1995 Sep;43(9):525-31.
Laryngeal carcinomas have different metastatic characteristics depending on their locations. Although these changes could be explained by differences in density of the lymphatic system, studies of the laryngeal lymphatic system have been controversial. To clarify these differences the lymphatic systems of 184 organ specimens were investigated with light and electron microscopy, histochemistry and injection techniques. Three types of lymphatic vessels were found in the larynx: lymph sinuses, precollectors and collectors. The highest density of lymphatics was found in the supraglottic larynx. From this region, lymph drained via 3-6 collectors to a hypopharyngeal collector. The subglottic lymph mainly drained via 2-4 collectors to paratracheal and mediastinal lymph nodes. The lymph system of the vocal folds was sparse but drained mainly to the supraglottic larynx. No lymph collector was found in the mucosa of the vocal fold. According to these results, the incidence of lymphatic spread correlated first with the density of the initial lymphatics in the various laryngeal regions and secondly (and probably of greater significance) with nearness of tumor to the laryngeal collectors.
喉癌因其位置不同而具有不同的转移特征。尽管这些差异可以通过淋巴系统密度的不同来解释，但关于喉淋巴系统的研究一直存在争议。为了阐明这些差异，我们采用光镜、电镜、组织化学和注射技术对184个器官标本的淋巴系统进行了研究。在喉中发现了三种类型的淋巴管：淋巴窦、初级集合淋巴管和集合淋巴管。声门上区的淋巴管密度最高。从该区域，淋巴液通过3 - 6条集合淋巴管引流至下咽集合淋巴管。声门下区的淋巴液主要通过2 - 4条集合淋巴管引流至气管旁和纵隔淋巴结。声带的淋巴系统稀疏，但主要引流至声门上区。在声带黏膜中未发现集合淋巴管。根据这些结果，淋巴转移的发生率首先与喉各区域初始淋巴管的密度相关，其次（可能更重要）与肿瘤距喉集合淋巴管的距离有关。
