声门上型喉癌声带不同活动情况组织病理学分析

目的 :探讨声门上型喉癌声带不同活动情况下的组织病理学特点 ,为喉部分切除术提供理论依据。方法 :84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 :声带固定 2 6例中杓状软骨、声门旁间隙下区以及两者同时受侵率分别为 4 6 .2 %、15 .4 %、38.5 % ;声带活动受限 30例中杓状软骨、声门旁间隙下区以及两者同时受侵率分别为 4 6 .7%、6 .7%、13.3% ;声带活动良好 2 8例中杓状软骨及声门旁间隙下区无受侵。声带固定、声带活动受限、声带活动良好 3组之间杓状软骨及声门旁间隙下区的受侵率差异有统计学意义 (P <0 .0 5 ) ;侵犯声门旁间隙下区的肿瘤均侵犯了喉室 ,声带活动受限及声带固定者中 ,肿瘤组织侵犯声门旁间隙下区占侵犯喉室比例分别为 4 0 .0 % (6 / 15 )、73.7% (14 / 19) ,两者之间差异有统计学意义 (P <0 .0 5 )。结论 :肿瘤侵犯杓状软骨及声门旁间隙下区是声门上型喉癌引起声带活动受限或固定的主要原因 ,观察声带活动及喉室的受侵情况 ,可为喉部分切除术提供参考依据。

Histopathology study of supraglottic carcinoma with different vocal cord movement

Objective:To explore the histopathology characteristics of supraglottic carcinoma with different vocal cord movement, and to find the theory basis for partial laryngectomy.Method:Eighty-four cases of supraglottic laryngeal carcinoma specimen were imbedded in collodion, and then make whole-organ serial section for HE staining, observing under light microscope.Result:For the vocal cord fixation, the rate of invasion to arytenoids, to infra-paraglottic space and to both arytenoids and infra-paraglottic space was 46.2 %, 15.4 %, and 38.5 %, respectively; For the vocal cord limitation, the rate of invasion to arytenoids, to infra-paraglottic space and to both arytenoids and infra-paraglottic space was 46.7 %, 6.7 %, and 13.3 %, respectively; For the vocal cord with good movement, no cases occurred for the invasion to the infra-paraglottic space or arytenoids.The difference was significant between them(P< 0.05 ). There was close relationship between the tumor invasion to infra-paraglottic space with to the ventricle of larynx:for the vocal cord limitation and fixation, the ratio of the tumor invading the infra-paraglottic space to the ventricle of larynx is 40.0% and 73.7%, respectively, the difference was significant between them(P< 0.05 ).Conclusion:The invasion of supra-glottic carcinoma to the arytenoids or infra-paraglottic space is the main cause of the vocal cord limitation and fixation. We can do the operation of partial laryngectomy more precisely by observing the movement of the vocal cord and the invasion to laryngeal ventricle.