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目的 :进一步探讨喉及下咽鳞癌颈淋巴结转移规律 ,为喉及下咽鳞癌颈淋巴结清扫术提供理论依据。方法 :收集 1997年 5月～ 1999年 7月 4 0例临床颈淋巴结阴性 ( c N0 )的喉及下咽鳞癌患者改良根治性颈清扫术所得标本 ,且术前未经任何治疗者为研究病例。对颈清扫淋巴结 (共 2 2 19枚 )进行常规 HE及免疫组化法检查。全部病例随访 1年以上。结果 :喉及下咽鳞癌出现颈淋巴结转移 14例 ( 3 5 % ) ,共 3 1枚 ( 1.4 % )淋巴结 ,其中声门上癌 6例 ( 6/2 0 ) ,跨声门癌 1例 ( 1/1) ,下咽癌 7例 ( 7/10 )。 9例声门癌无颈淋巴结转移。颈淋巴结转移均位于颈 、 区。结论 :喉及下咽鳞癌颈淋巴结转移多发生于患侧颈 、 区 (局限于声门区喉癌除外 )。对于 T2 ～ T4 声门上癌、跨声门癌及下咽癌的 c N0 患者 ,根据其可能发生颈淋巴结隐匿性转移的高危险性 ,建议行患侧或双侧颈 及 区淋巴结清扫术。
Objective: To further explore the rule of cervical lymph node metastasis of laryngeal and hypopharyngeal squamous cell carcinoma and to provide theoretical basis for laryngeal and hypopharyngeal squamous cell carcinoma neck lymph node dissection. Methods: From May 1997 to July 1999, 40 patients with clinically neck lymph node-negative (c N0) throat and squamous cell carcinoma of the lower extremity underwent modified radical neck dissection, and the patients without any treatment were studied before surgery Case. Neck dissection lymph nodes (a total of 2 2 19) for routine HE and immunohistochemistry. All cases were followed up for more than 1 year. Results: There were 14 cases (35%) of cervical lymph node metastasis in laryngeal and squamous cell carcinoma, with a total of 31 lymph nodes (1.4%), including 6 cases of supraglottic carcinoma (6/2), 1 case of transglottic carcinoma (1/1), hypopharyngeal cancer in 7 cases (7/10). 9 cases of glottic cancer without cervical lymph node metastasis. Cervical lymph node metastasis are located in the neck, area. CONCLUSIONS: Laryngeal and squamous cell carcinoma of the neck lymph node metastasis occurred in the affected side of the neck, the area (limited to the glottic laryngeal cancer except). For patients with T2-T4 supraglottic, transglottic and hypopharyngeal cancers, it is recommended that ipsilateral or bilateral neck and regional lymphadenectomy be performed according to their high risk of occult cervical lymph node metastasis.