声门上型喉癌cN0患者颈部淋巴结转移的相关因素分析

目的分析声门上型喉癌eN0患者颈部淋巴结转移的相关因素。方法回顾分析41例声门上型喉癌cN0患者的临床资料，分析cN0不同T分级及病理分型患者颈部淋巴结转移的情况和颈部淋巴结转移的分布。结果41例声门上型喉癌颈部淋巴结隐性转移率39．0％。其中T2为14．3％，T3为45．8％，T4为66．7％；T1＋T2组与T3＋T4组之间比较，差异具有统计学意义（P〈0．05）。按病理分型分类，其中高分化鳞癌转移率27．3％，中分化鳞癌40．0％，低分化鳞癌55．6％，各型之间比较差异均无统计学意义（P均〉0．05）。结论声门上型喉癌cN0患者颈部淋巴结转移与T分级密切相关，淋巴结转移多发于Ⅱ区和Ⅲ区，其次为IV区；对声门上型喉癌eN0患者颈部淋巴结的处理可择区行颈淋巴结廓清术。

The related factors in cervical lymph node metastasisin patients with supraglottic carcinoma of cN0 stage

Objective To analyze the patterns and related factors in cervical lymph node metastasis in patients with supraglottic carcinoma of cN0 stage. Methods Clinical data of 41 patients with supraglottic carcinoma of cN0 stage was analyzed retrospectively. The cervical lymph node metastasis rate, distribution of metastatic lymph nodes was evaluated. Their relations with T stage and pathologic differentiation were analyzed. Results The total occult lymphatic metastasis rate was 39.0% . Grouped according to T classification, the metastatic rates in group T1 , T2, T3 and T4 were 0, 14.3% , 45.8% , and 66.7% respectively. And the difference between groups T1 ＋ T2 and T3 ＋ T4 was statistically significant （ P 〈 0. 05 ）. Grouped according to pathological differentiation of tumor, the metastatic rates in groups of well, middle and poor differentiation were 27.3 % , 40.0% and 55.6% respectively, while the differences among them were statistically insignificant （ P 〉 0. 05 ）. Conclusions Cervical lymph node metastasis in patients with supraglottic carcinoma of cN0 stage is related with T classification of tumor, and metastatic lymph nodes mainly locate at lateral levels Ⅱ, Ⅲfollowed by IV. Therefore, selective jugular dissection is reasonable for the patients with supraglottic carcinoma of cN0 stage.