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目的:探讨声门上型喉癌局部浸润与淋巴结转移的关系。方法:66例声门上型喉癌喉切除标本,经火棉胶包埋,制成连续切片,苏木精-伊红染色,光学显微镜下观察。结果:有淋巴结转移的声门上喉癌对会厌前间隙,声门旁间隙上、下区的侵犯率分别为100.0%(18/18)、83.3%(15/18)、44.4%(8/18),均高于无淋巴结转移声门上型喉癌,两者差异有统计学意义(P<0.05);有淋巴结转移声门上喉癌会厌前间隙全部受累率为55.5%(10/18),与无淋巴结转移喉癌29.1%(14/48)相比差异有统计学意义(P<0.05)。淋巴结转移喉癌侵犯声门旁间隙上区的宽度及高度分别为(7.4±5.2)mm,(11.6±7.6)mm,侵犯声门旁间隙下区的宽度及高度分别为(2.9±3.8)mm,(2.4±3.7)mm,这两者均大于无淋巴结转移组喉癌,差异有统计学意义(P<0.05);淋巴结转移组声门上型喉癌声带活动良好、声带固定率分别为11.1%(2/18),44.4%(8/18),与无淋巴结转移喉癌相比,差异有统计学意义(P<0.05)。结论:有淋巴结转移的声门上型喉癌具有较强的局部侵袭能力,对会厌前间隙及声门旁间隙的侵犯是其重要特征。
Objective: To investigate the relationship between local infiltration of supraglottic laryngeal carcinoma and lymph node metastasis. Methods: Sixty-six cases of laryngectomy of supraglottic laryngeal carcinoma were embedded in fire cotton gum, and were made into serial sections. Hematoxylin-eosin staining and optical microscopy were performed. Results: The rates of the supraglottic glottic cancer with lymph node metastasis were 100.0% (18/18), 83.3% (15/18) and 44.4% (8 / 18) were higher than those without lymph node metastasis of supraglottic laryngeal carcinoma, the difference was statistically significant (P <0.05); with lymph node metastasis supraglottic larynx anaphylactoid space total involvement rate was 55.5% (10/18 ) Compared with 29.1% (14/48) without lymph node metastasis (P <0.05). The width and height of the supraglottic gland in the patients with lymph node metastasis of laryngeal cancer were (7.4 ± 5.2) mm and (11.6 ± 7.6) mm, respectively. The width and height of the inferior glottic paragangular space were (2.9 ± 3.8) mm , (2.4 ± 3.7) mm, both of which were significantly higher than those without lymph node metastasis (P <0.05). The vocal folds of the supraglottic laryngeal carcinoma in lymph node metastasis were good and the fixation rates of vocal cord were 11.1 % (2/18), 44.4% (8/18) respectively. There was a significant difference between the two groups (P <0.05). Conclusion: The supraglottic laryngeal carcinoma with lymph node metastasis has a strong local invasion ability, and the invasion to the anterior epiglottic space and glottic space is an important feature.