喉疣状癌的临床分析

目的：分析喉疣状癌的临床病理特点、手术方式和疗效。方法：经病理证实的喉疣状癌患者10例，5例行垂直半喉+重建术；2例行环状软骨上喉部分切除+环舌会厌吻合术（CHEP）；2例行支撑喉镜下YAG激光声带切除术，其中1例术后放疗，另1例4个月后原位复发，行垂直半喉+重建术后控制；1例行喉裂开声带切除术。结果：所有患者均恢复正常的呼吸和吞咽功能，9例插管患者拔除气管套管后均获得正常的发音功能。术后随访：1例患者原位复发，1例因其他部位肿瘤死亡，2例因心脑血管疾病死亡。全部患者手术部位癌细胞无远处转移，5年生存率75%。结论：喉疣状癌是高分化鳞状细胞癌的一种特殊类型，本病确诊有赖于病理专家与喉科医师密切配合。手术是喉疣状癌主要的治疗方式，在切除肿瘤的基础上保留喉功能，提高患者生活质量

Clinical analysis of laryngeal verrucous carcinoma

To investigate the clinical pathological characteristics and the treatment of laryngeal verrucous carcinoma. Methods： Ten cases of laryngeal verrucous carcinoma were performed by surgery, including verticval partial laryngectomy in 5 patients, supracricoid laryngectomy and cricohiodoepiglottopexy in 2, laryngeal cleft and cordectomy in 1, and laser in 2. Moreover, radiotherapy was performed in one afer surgery, verticval partial laryngectomy was performed in one recurring four months after surgery. Results： Breathing and deglutition function recovered in all; normal voice function was got after decannulation in 9. During the follow up period, 1 patient relapsed; 1 died of other position tumor; 2 died of cardia cerebrovascular disease. No distant metastasis was found. The overall 5 year survival rate was 75%. Conclusion: Verrucous carcinoma of the larynx is a special pattern of the hyper differentiated squamous cancer. A correct diagnosis requires close cooperation between the laryngologist and the histopathologist. The main treatment of verrucous carcinoma is based on complete excision to reserve larynx function and improve the quality of life.