论文部分内容阅读
目的:研究梨状窝癌同期颈淋巴结转移特点和规律。方法:回顾性分析102例梨状窝癌临床、病理资料,并对其颈淋巴结同期转移的特点和分布规律等情况进行统计分析。结果:T1、T2、T3和T4梨状窝癌同期颈淋巴结转移率分别为16.7%、59.4%、70.8%和63.6%。T1梨状窝癌同期颈淋巴结转移率与T2、T3和T4梨状窝癌同期颈淋巴结转移率相比均差异有统计学意义(均P<0.05)。T2、T3和T4梨状窝癌同期双侧颈淋巴结转移分别为2.7%(1/37)、12.5%(6/48)、18.1%(2/11),T2和T3、T4之间梨状窝癌同期双侧颈淋巴结转移率相比均差异有统计学意义(均P<0.05)。14例无颈淋巴结转移(cN0)梨状窝癌行改良颈清扫术,术后病理证实有10例出现颈淋巴结转移,转移率达71.4%。64例梨状窝癌73侧出现同期颈淋巴结转移,转移区域主要集中在Ⅱ区、Ⅲ区和Ⅳ区,其转移例次构成比分别为33.55%、30.97%和25.16%;而Ⅰ区、Ⅴ区、Ⅵ区转移率较低,分别为3.87%、5.16%和1.29%。cN0和cN1转移淋巴结全分布在Ⅱ、Ⅲ和Ⅳ区,无Ⅰ区、Ⅴ区和Ⅵ区转移。cN0梨状窝癌Ⅱ、Ⅲ和Ⅳ区转移率分别为46.7%、33.3%和20.0%,cN1梨状窝癌Ⅱ、Ⅲ和Ⅳ区转移例次构成比分别为41.7%、33.3%和25.0%。cN2和cN3除Ⅱ、Ⅲ和Ⅳ区转移外,尚有少数病例出现Ⅰ区、Ⅴ区、Ⅵ区转移。结论:T2、T3和T4梨状窝癌易发生同期颈淋巴结转移;T3和T4梨状窝癌易发生同期双侧颈淋巴结转移;T3、T4梨状窝癌和颈淋巴结双侧转移的梨状窝癌较易出现转移淋巴结包膜外侵;cN0和cN1转移淋巴结全部分布在Ⅱ、Ⅲ和Ⅳ区;cN2和cN3转移淋巴结主要分布在Ⅱ、Ⅲ和Ⅳ区转移,Ⅰ、Ⅴ、Ⅵ区转移相对较少。
Objective: To study the characteristics and regularity of cervical lymph node metastasis in pear-shaped litter. Methods: The clinical and pathological data of 102 cases of pear-shaped carcinoma were retrospectively analyzed. The characteristics and distribution of cervical lymph node metastasis were analyzed statistically. Results: The rates of cervical lymph node metastases in T1, T2, T3 and T4 cases were 16.7%, 59.4%, 70.8% and 63.6%, respectively. The metastasis rate of cervical lymph node in T1-L1 cervical carcinoma was significantly different from that of cervical lymph node metastases in T2, T3 and T4 (all P <0.05). The rates of bilateral cervical lymph node metastases in T2, T3 and T4 cases were 2.7% (1/37), 12.5% (6/48) and 18.1% (2/11), respectively There was significant difference in the metastasis rate of bilateral cervical lymph nodes between the two groups (all P <0.05). Fourteen cases of cervical lymph node metastasis (cN0) were treated by modified neck dissection. Ten cases had cervical lymph node metastasis and the rate of metastasis was 71.4%. The metastatic cervical lymph nodes were found in 73 cases of 64 cases of infiltrating carcinoma of the popliteal area. The metastatic areas mainly concentrated in the areas of area Ⅱ, area Ⅲ and area Ⅳ, the transfer times were 33.55%, 30.97% and 25.16% Area, Ⅵ area transfer rate is lower, respectively, 3.87%, 5.16% and 1.29%. The cN0 and cN1 metastatic lymph nodes were completely distributed in the Ⅱ, Ⅲ and Ⅳ regions, with no metastases in the Ⅰ, Ⅴ and Ⅵ regions. The metastatic rates of stage Ⅱ, Ⅲ and Ⅳ in cN0 pear carcinoma were 46.7%, 33.3% and 20.0% respectively, and those of metastases in cN1 pear Ⅲ, Ⅲ and Ⅳ zones were 41.7%, 33.3% and 25.0% . In addition to the metastases of cN2 and cN3, there are still a few cases of metastases in areas Ⅰ, Ⅴ and Ⅵ. CONCLUSIONS: Cervical lymph node metastasis is likely to occur in T2, T3 and T4 cases, while cervical lymph node metastases in T3 and T4 are more likely to occur in bilateral cervical lymph nodes. The metastasis of cN0 and cN1 metastatic lymph nodes were all located in Ⅱ, Ⅲ and Ⅳ. The metastatic lymph nodes of cN2 and cN3 were mainly located in metastasis Ⅱ, Ⅲ and Ⅳ, metastasis Ⅰ, Ⅴ and Ⅵ Relatively small.