摘要
目的了解不同部位、不同T分级及不同形态的喉癌组织黏膜下浸润程度,探讨肿瘤黏膜下浸润程度对喉癌手术切缘的影响。方法收集43例喉癌患者的整块手术切除标本,沿肿瘤长轴垂直切开标本并制作切片,低倍镜下观察并测出喉癌组织在黏膜下潜性浸润距离。比较不同部位、不同T分级及不同形态的喉癌组织黏膜下浸润情况。结果结合肿瘤的外观形态特征及肿瘤浸润程度,在以往肿瘤大体分型的基础上,将喉癌归类为外生型、溃疡浸润型和混合浸润型。43例喉癌标本中,外生型10例,溃疡浸润型8例,混合浸润型25例。喉癌T1～T2级与T3～T4级之间有统计学差异;喉癌外生型、溃疡浸润型和混合浸润型,前者分别与后两型比较,均有显著性差异。结论除喉癌的黏膜病变外,肿瘤的黏膜下浸润程度对确定喉癌原发灶的外科切缘也有重要的指导意义。喉癌原发灶T分级越晚,肿瘤黏膜下浸润程度越重。外生型喉癌的黏膜下浸润程度轻,溃疡浸润型、混合浸润型喉癌黏膜下浸润程度重。局部晚期的溃疡浸润型、混合浸润型喉癌应慎行喉部分切除术。
OBJECTIVE To observe the submucosal infiltrating extent of laryngeal carcinoma tissue by different location,different T staging and external appearance and to analyze the impact of laryngeal carcinoma submucosal infiltrating extent on surgical margin.METHODS Forty-three laryngeal en bloc specimens coming from 43 cases with laryngeal carcinoma were vertically cut-down along tumor long axis,and were slivered into sections by which laryngeal carcinoma submucosal infiltrating distance was measured under microscope.Laryngeal carcinoma latent submucosal infiltrating extent was compared among different location,different T staging and external appearance.RESULTS Basing on tumor external appearance and infiltrating extent,laryngeal carcinoma was classified into three types:exogenic type,ulcerating infiltrating type and mixed infiltrating type.Of 43 specimens,the three types were 10,8 and 25 cases respectively.There was a significant difference in submucosal infiltrating extent between T1～T2 and T3～T4 laryngeal carcinoma.There was also significant difference in submucosal infiltrating extent between exogenic type and ulcerating infiltrating type or mixed infiltrating type.CONCLUSION The submucosal infiltrating extent of laryngeal carcinoma tissue plays an important role in the surgical margin. As laryngeal carcinoma T stage developing,tumor submucosal infiltrating extent is becoming more extensive.Laryngeal carcinoma submucosal infiltrating extents in ulcerating infiltrating and mixed infiltrating type are more extensive than that in exogenic type.The partial laryngectomy should be prudent to be performed in cases with local advanced ulcerating infiltrating and mixed infiltrating laryngeal carcinoma.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2008年第7期384-387,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
喉肿瘤
喉黏膜
病理状态
解剖学
Laryngeal Neoplasms
Laryngeal Mucosa
Pathological Conditions,Anatomical
