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目的 :探讨喉癌、下咽癌患者颈淋巴结转移的特点和分布规律。方法 :对全喉切除术同期及复发后第 1次行颈淋巴结清扫的 12 9例喉癌、下咽癌患者的临床资料进行回顾性对比分析 ,研究不同类型的喉癌、下咽癌患者颈淋巴结的转移情况。结果 :声门上型喉癌、下咽癌患者易发生早期淋巴结转移 ;下咽癌患者的转移淋巴结融合率高 ,颈静脉下区出现阳性淋巴结的比率高 ;声门上型喉癌、下咽癌患者原发病灶分化差的比率相对偏高 ;同期与复发后行颈淋巴结清扫的患者原发病灶分期差异无显著性意义。结论 :对T2 期及以上的声门上型喉癌及下咽癌患者 ,尤其当细胞分化比较差时 ,即使颈淋巴结阳性体征不明显亦应积极考虑颈淋巴结清扫问题 ,对下咽癌患者行颈淋巴结清扫时应考虑彻底清扫颈静脉下区的淋巴结
Objective: To investigate the characteristics and distribution of cervical lymph node metastasis in patients with laryngeal cancer and hypopharyngeal cancer. Methods: The clinical data of 129 laryngeal and hypopharyngeal cancer patients undergoing total laryngectomy at the same period and after the first recurrence of cervical lymph node dissection were analyzed retrospectively to study the clinical features of different types of laryngeal and hypopharyngeal cancer patients Lymph node metastasis. Results: The patients with supraglottic carcinoma and hypopharyngeal carcinoma were prone to early lymph node metastasis. The patients with hypopharyngeal carcinoma had high fusion rate of metastatic lymph nodes and high rate of positive lymph nodes in the jugular vein. The supraglottic laryngeal carcinoma and hypopharynx The rate of poor differentiation of primary lesion in cancer patients was relatively high. There was no significant difference in staging of primary lesion in patients with neck lymph node dissection at the same period and after recurrence. Conclusion: For patients with supraglottic and hypopharyngeal carcinoma of stage T2 and above, especially when the cell differentiation is poor, positive cervical lymph node dissection should be considered even if the positive signs of cervical lymph nodes are not obvious. For patients with hypopharyngeal carcinoma Neck lymph node dissection should be considered to thoroughly clean the lower jugular lymph nodes