喉气管腺样囊性癌10例临床分析

目的 探讨喉气管腺样囊性癌的临床特点、治疗方法及预后。方法 回顾性分析10例行喉气管腺样囊性癌的临床资料，根据UICC　2002年TNM分期标准，喉腺样囊性癌T1N0M0 1例，T2N0M0 1例，T3N0M0 3例；根据Bhattacharwa分期，气管腺样囊性癌T1N0M0 1例，T2N0M0 3例，T3N0M0 1例。10例患者临床上以喉痛、声嘶、咳嗽及进行性呼吸困难伴喘鸣等为主要表现形式，采取手术加术后辅助放疗的治疗模式。喉腺样囊性癌以喉全切除术和喉部分切除术为主，气管腺样囊性癌以气管袖状切除加端端吻合术为主。术后辅助放疗，采用调强放疗方式，总剂量 60～70Gy。结果 10例患者术后愈合好，无并发症，随访时间为2个月～7年不等，所有病例均未见局部复发及远处转移。结论 喉气管腺样囊性癌临床上以进行性呼吸困难伴喘鸣、咳嗽及声嘶为主，纤维喉镜检查有利于早期发现。该病颈淋巴转移率低，预后较好。根治性切除加术后辅助放疗是治疗喉气管腺样囊性癌的最佳方法。

Clinical analysis of adenoid cystic carcinoma of larynx and trachea (10 case report)

Objective To explore the clinical characteristics, treatment and outcome of adenoid cystic carcinoma(ACC) of the larynx and trachea. Methods Clinical data of 10 patients with ACC in larynx and trachea was reviewed. Among theses cases, there were 1 T1N0M0，1 T2N0M0，3 T3N0M0 of laryngeal ACC (UICC2002 TNM staging), and 1 T1N0M0, 3 T2N0M0 , 1 T3N0M0 of tracheal ACC (Bhattacharwa staging). Laryngalgia, hoarseness, cough and progressive dyspnea accompanied with stridor were the main complaints. Surgery plus postoperative radiotherapy was applied to all the cases. Total/partial laryngectomy or sleeve resection of trachea followed by anastomosis were performed for ACC of larynx and trachea. The dose of intensity modulated radiotherapy varied from 60-70Gy. Results 10 patients recovered well without complications. Neither local recurrence nor metastasis was noted during the follow up from 2 months to 7 years. Conclusion With progressive dyspnea accompanied with stridor, cough and hoarseness, ACC of the larynx and trachea features low cervical lymph node metastasis and good prognosis. It can be detected early by laryngoscope. Surgery combined with postoperative radiotherapy is the best treatment for this disease.