头颈部鳞癌与甲状腺癌颈清扫术的选择方式及其效果对比研究

目的　探讨头颈部鳞癌与甲状腺癌颈清扫术选择方式 ,对比其效果。方法　回顾性分析 5 80例颈清扫术临床资料 ,其中头颈部鳞癌组 35 7例 ,甲状腺癌组 2 2 3例。结果　两组性别、年龄、临床分期和转移淋巴结浸润程度有显著性差异。根治性颈清扫术治疗两组的 5年、10年生存率及功能性颈清扫术治疗两组的 10年生存率均有显著性差异 ,功能性颈清扫术治疗两组的 5年生存率无差异。选择同一术式的两组例数有显著性差异。两组的分区性颈清扫术无显著性差异 ,但清扫点不同。病理类型、临床分期和转移淋巴结浸润程度为独立的预后因素。结论　因两种癌生物学特性不同 ,颈清扫术时不能按照临床分期一视同仁 ,对头颈部鳞癌的清扫术应比甲状腺癌的清除范围要扩大。

The contrast and selection of neck dissection in squama carcinoma of head and neck and thyroid Carcinoma

Objective To study how to select the neck dissection of squama carcinoma of head and neck and thyroid carcinoma, and to contrast the effect of them.Methods The clinical data of 580 cases of neck dissection were retrospectively analyzed, among them, there were 357 cases of squama carcinoma of head and neck and 223 cases of thyroid carcinoma.Results Statistically significant difference was found among these tow groups in the gender, age, clinic stage and degree of infiltration of lymph node with tumor metastasis. The 5 or 10-survival rate of thyroid carcinoma are higher than that of squama carcinoma of head and neck in radical or modified neck dissection but not in 5-survival rate in modified neck dissection. The cases among these tow groups are significant difference in the same surgical management without selective neck dissection, the bound of dissection are not significant difference in selective neck dissection. The pathological types, clinical stage and degree of infiltration of lymph node with tumor metastasis are independent prognosis factors.Conclusion Becauses of the difference biological characteristic, the surgical management cannot treat equally without discrimination in the tow cancinomas treatment in term of clinical stage.The bound of dissection for squama carcinoma of head and neck are broader than thyroid carcinoma.