声门上型喉癌颈淋巴结隐匿性转移的病理特点

目的　探讨声门上型喉癌颈淋巴结隐匿性转移的病理特点和规律 ,帮助临床治疗。方法　对 10 0例临床N0 的声门上型喉癌患者和颈廓清标本 ( 153侧 )进行连续切片 ,光镜观察。结果　隐匿性转移率为 38%。发现转移淋巴结 51个 :Ⅰ区 1个 ( 2 % )、Ⅱ区 37个 ( 73% )、Ⅲ区 12个 ( 2 3% )、Ⅳ区1个 ( 2 % )。转移淋巴结的长径 0 5- 2 6cm ,平均为 1 1cm。 51个淋巴结中 ,癌早期 2 1个 ( 4 1% )、癌长期 18个( 35% )、癌满期 7个 ( 14% )、破膜期 5个 ( 10 % )。结论　声门上型喉癌颈淋巴结的隐匿性转移率高 ,早期不易诊断 ,应积极行选择性颈廓清术。

Pathologic features of occult lymphatic metastasis in supraglottic carcinoma

Objective　To study the pathologic features of occult lymphatic metastasis in supraglottic carcinoma.Methods　Serial sections of 153 neck dissection specimens in 100 patients with supraglottic carcinoma were evaluated under the microspcope.Results　In 100 patients, 38 had occult metastatic lymph nodes. 51 metastatic lymph nodes were found in pathology, and their sizes ranged from 0.5?cm to 2.6?cm (average 1.1?cm). The distribution of 51 lymph nodes was 1 in level Ⅰ (2%), 37 in level Ⅱ (73%), 12 in level Ⅲ (24%), and 1 in level Ⅳ (2%). Among the 51 nodes, 21 (41%) were early stage, 18 (35%) were growth stage, 7 (14%) were tull stage, and 5 (10%) were extracapsular stage. The differentiation degree and appearance of supraglottic carcinoma was not directly related with occult metastasis.Conclusion　The occult metastatic rate of supraglottic carcinoma is high, and selective neck dissection may be necessary.