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背景与目的:功能性颈淋巴结清扫术自1967年Bocca提出后,在头颈外科临床中已被推广应用,但对其临床应用适应证及其临床根治效果,国内外头颈外科专家持有不同观点。本研究旨在探索功能性颈淋巴结清扫术临床应用适应证和临床根治效果。方法:对152例次功能性颈淋巴结清扫术病例,利用手术标本病理检查及随诊资料进行分析讨论。结果:152例次功能性颈清扫术,舌鳞癌20例次,喉鳞癌23例次,甲状腺乳头状癌96例次,滤泡状腺癌9例次,髓样癌4例次;舌、喉鳞癌N0、N1、N2a病例术后5年复发率分别为12.5%、14.3%、40.0%和20%、16.7%、50.0%,甲状腺乳头状腺癌N1a、N1b病例术后5年复发率分别为:6.5%、7.1%。结论:功能性颈淋巴结清扫术适用于较早期及低度恶性的头颈肿瘤手术治疗,且可获得良好的临床根治效果。
BACKGROUND & OBJECTIVE: Functional cervical lymph node dissection has been widely used in the treatment of head and neck surgery since Bocca was proposed in 1967. However, its clinical application indications and its clinical curative effect have different opinions from domestic and foreign experts in head and neck surgery. This study aimed to explore functional clinical lymph node dissection indications and clinical curative effect. Methods: 152 cases of sub-functional cervical lymph node dissection cases, the use of surgical specimens of pathological examination and follow-up data analysis and discussion. Results: A total of 152 cases of functional neck dissection were performed in 20 cases of tongue squamous cell carcinoma, 23 cases of laryngeal squamous cell carcinoma, 96 cases of thyroid papillary carcinoma, 9 cases of follicular adenocarcinoma and 4 cases of medullary carcinoma. . The recurrence rates at 5 years after laryngeal squamous cell carcinoma in patients with N0, N1 and N2a were 12.5%, 14.3%, 40.0% and 20%, 16.7% and 50.0%, respectively. The recurrence rates of N1a and N1b in patients with thyroid papillary adenocarcinoma 5 years after operation Rates were: 6.5%, 7.1%. Conclusion: Functional cervical lymph node dissection is suitable for early and low-grade surgical treatment of head and neck cancer, and can obtain good clinical curative effect.