摘要
目的总结T2~T4喉癌颈淋巴结转移规律,并分析其相关因素,探讨T2~T4喉癌颈淋巴结处理规范。方法回顾2002-12-16-2013-01-07首都医科大学附属北京同仁医院401例行喉部开放性手术治疗的T2~T4NXM0喉癌患者,应用Logistic回归分析喉癌淋巴结转移相关因素,Cox回归分析喉癌死亡危险因素,研究其颈淋巴结转移规律及相关因素。结果本组中晚期喉癌颈淋巴结总体转移24.4%（98/401）。Logistic回归分析结果提示,T分级（P=0.014）、喉癌分型（P=0.001）及病理（P=0.009）分级是喉癌淋巴结转移的相关因素,Ⅱ、Ⅲ、Ⅳ和ⅡB区的隐性转移率分别为17.2%（69/401）、16.7%（67/401）、2.5%（10/401）和1.5%（6/401）。全组1、3和5年生存率分别为98%、83%和79%。Cox回归分析发现,淋巴结转移（P〈0.001）与T分级（P=0.001）是喉癌死亡的危险因素,而喉癌分型对于喉癌预后影响差异无统计学意义。结论喉癌颈部淋巴结转移的发生与肿瘤的分型、T分级有关,不同分型喉癌的颈淋巴结转移区域有一定规律性,颈淋巴结转移是导致喉癌死亡的重要因素之一,应根据喉癌的不同分型和T分级处理颈淋巴结。
OBJECTIVE To investigate the metastatic rules of lymph node in patients with T2 --T4 laryngeal carcinoma and explore the correlative factors contributing to the metastasis, then standardize the treatment method of T2- T4 laryngeal carcino- ma. METHODS Totally 401 patients with ＂I＂2 T4 laryngeal carcinoma who received laryngectomy from December 2002 to Januar- y 2013 were retrospectively analyzed. All the information were analyzed by SPSS 17.0 software, correlative factors of cervical lymph node metastasis were analyzed by logistic regression analysis, and Cox regression analyses were conducted to predict prog- nosis. RESULTS The overall metastatic rates of laryngeal carcinoma was 24. 4% （98/401）. The factors of T staging（P= 0. 014） ,type （P=0. 001） and pathology degrading （P=0. 009） were correlated to lymph node metastasis. The metastatic rates of level Ⅱ,Ⅲ ,IV and liB were 17.2%（69/401） ,16.7%（67/401） ,2.5%（10/401） and 1.5% （P〈0. 001） for laryngeal carcinoma, respectively. The overall 1-, 3-and 5-year survival rates were 98%, 83 % and 79 %, respectively. Cox regression analysis showed lymph node metastasis and T staging（P=0. 001） were the risky factors for the survival,but the type seemed with no statistic re- lationship with the prognosis of laryngeal cancer. CONCLUSIONS The metastatic rates of cervical lymph nodes tend to be related with T stages and types of of laryngeal carcinoma. Moreover, there is a certain sequential pattern for the metastasis of cervical lymph nodes according to the regions involved,and lymph node metastasis is one of the most important factors which leading to the death of laryngeal carcinoma.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第7期542-547,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
国家自然科学基金(81272267)
教育部高校博士点基金(20121107110021)
北京市科委首都特色项目重点资助课题(Z14110700251400)
北京市医管局扬帆计划资助项目(XMLX20131)
首都医科大学附属北京同仁医院科研骨干培育基金资助课题(2014-YJJ-GGL-047)
关键词
喉癌
淋巴结转移
预后
治疗
laryngeal cancer lymph node metastasis prognosis therapy
