本文關(guān)鍵詞： 聲門型喉癌 復(fù)發(fā) 第二原發(fā)癌　出處：《安徽醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的探討喉內(nèi)第二原發(fā)癌與聲門型喉癌術(shù)后復(fù)發(fā)的關(guān)系及聲門型喉癌術(shù)后復(fù)發(fā)的原因。 方法隨訪2001年10月至2009年10月的單側(cè)聲門型喉癌T1-T3期的病例。術(shù)后超過(guò)3年的的患者,統(tǒng)計(jì)復(fù)發(fā)部位為對(duì)應(yīng)殘喉的比例;對(duì)于術(shù)后1-3年病例,行電子喉鏡檢查,對(duì)側(cè)聲帶可疑病例者行活檢;現(xiàn)病例,術(shù)中同時(shí)行對(duì)側(cè)聲帶前中1/3處活檢進(jìn)行病理學(xué)檢查。對(duì)術(shù)后1-3年及現(xiàn)病例的患者對(duì)側(cè)聲帶癌變復(fù)發(fā)以及有癌前病變的病例與對(duì)側(cè)聲帶無(wú)病變的病例進(jìn)行病因分析。 結(jié)果術(shù)后隨訪3-8年的患者84例,共復(fù)發(fā)21例,其中原發(fā)部位局部復(fù)發(fā)10例,頸部復(fù)發(fā)5例,原發(fā)部位以外的對(duì)側(cè)半喉復(fù)發(fā)6例,該組對(duì)側(cè)半喉復(fù)發(fā)率為7.2%,占術(shù)后總復(fù)發(fā)者28.6%;術(shù)后1-3年55例,術(shù)后不同部位復(fù)發(fā)共6例,其中對(duì)側(cè)半喉復(fù)發(fā)1例,復(fù)發(fā)率為1.8%,占術(shù)后總復(fù)發(fā)者16.6%,術(shù)后1-3年55例中對(duì)側(cè)聲帶有不典型增生12例;現(xiàn)病例30例2008年10月至2009年10月共收集新住院?jiǎn)蝹?cè)聲門型喉癌病例㖞,對(duì)側(cè)聲帶同時(shí)有癌變者2例,不典型增生者7例,無(wú)病變者21例。術(shù)后1-3年病例中,家族有無(wú)遺傳史、患者術(shù)后是否吸煙、放療以及有無(wú)食管反流對(duì)于對(duì)側(cè)聲帶是否發(fā)生癌變或癌前病變有一定的影響,經(jīng)統(tǒng)計(jì)學(xué)分析差異皆有顯著性(P分別為0.006、0.003、0.029、0.020);術(shù)前不同T分期對(duì)于對(duì)側(cè)聲帶是否發(fā)生癌變或癌前病變無(wú)統(tǒng)計(jì)學(xué)意義(P=0.980)�，F(xiàn)病例中,家族有無(wú)遺傳史、患者術(shù)前是否吸煙、飲酒以及有無(wú)喉咽反流對(duì)于對(duì)側(cè)聲帶是否發(fā)生癌變或癌前病變有一定的影響,經(jīng)統(tǒng)計(jì)學(xué)分析差異皆有顯著性(P分別為0.034、0.029、0.039、P=0.008);術(shù)前不同T分期對(duì)于對(duì)側(cè)聲帶是否發(fā)生癌變或癌前病變無(wú)統(tǒng)計(jì)學(xué)意義(P=0.841)。 結(jié)論喉內(nèi)對(duì)側(cè)半喉復(fù)發(fā)(喉內(nèi)第二原發(fā)癌)是聲門型喉癌復(fù)發(fā)的重要原因之一,隨著隨訪時(shí)間的延長(zhǎng),復(fù)發(fā)的幾率增大。家族有遺傳史、術(shù)后吸煙飲酒、食管反流等是術(shù)后對(duì)側(cè)半喉復(fù)發(fā)的重要致病因素。
[Abstract]:Objective to investigate the relationship between intralaryngeal second primary carcinoma and postoperative recurrence of glottic laryngeal carcinoma and the causes of postoperative recurrence of glottic laryngeal carcinoma. Methods patients with unilateral glottic carcinoma of stage T1-T3 were followed up from October 2001 to October 2009. The recurrence sites of the patients more than 3 years after operation were counted as the proportion of residual larynx, and the laryngoscopy was performed for 1-3 years after operation. Biopsy of suspected cases of contralateral vocal cords; present case, Pathological examination was performed at 1/3 biopsy sites of the contralateral vocal cord at the same time during the operation. Etiological analysis was carried out in patients with recurrence of contralateral vocal cord cancer and cases with precancerous lesions and cases with no lesion of contralateral vocal cord in 1-3 years and present cases. Results 84 cases were followed up for 3 to 8 years, 21 cases recurred, including 10 cases of local recurrence of primary site, 5 cases of neck recurrence and 6 cases of contralateral hemilarynx recurrence outside the primary site. The recurrence rate of contralateral half larynx was 7.2, accounting for 28.6% of the total recurrence rate, 55 cases in 1-3 years after operation, 6 cases of recurrence in different parts of the group, and 1 case of recurrence of contralateral half larynx. The recurrence rate was 1.8%, accounting for 16.6% of the total recurrence after operation, 12 cases of contralateral vocal cord dysplasia were found in 55 cases in 1-3 years after operation, 30 cases were present cases? From October 2008 to October 2009, a total of hospitalized cases of unilateral glottic laryngeal carcinoma were collected. , 2 cases of contralateral vocal cord carcinogenesis, 7 cases of atypical hyperplasia, 21 cases of no pathological changes. Radiotherapy and esophageal reflux have some effects on the carcinogenesis or precancerous lesion of the contralateral vocal cord. There were significant differences between the two groups (P = 0.006, P = 0.003, P = 0.029, P = 0.020, respectively). There was no significant difference in whether the contralateral vocal cord carcinogenesis or precancerous lesion occurred in different T stages before operation. There was no significant difference between the two groups. In the present case, there was no genetic history in the family and whether the patient smoked before operation. Alcohol consumption and the presence of laryngopharyngeal reflux may have an effect on the carcinogenesis or precancerous lesion of the contralateral vocal cord. There were significant differences between the two groups (P = 0.034, 0.029, 0.039, P 0.008, respectively), and there was no significant difference between different T stages before operation in the development of carcinogenesis or precancerous lesion of the contralateral vocal cord. Conclusion the recurrence of the contralateral half larynx (the second primary carcinoma of the larynx) is one of the important reasons for the recurrence of glottic laryngocarcinoma. With the extension of follow-up time, the recurrence rate increases. Esophageal reflux is an important risk factor for the recurrence of contralateral half larynx.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R739.65

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳艷峰,陳福進(jìn),楊安奎,曾宗淵,宋明,李秋梨;復(fù)發(fā)性喉癌患者的臨床特點(diǎn)和影響預(yù)后因素的分析[J];癌癥;2004年05期

2 范黎,于釗,任軍,鄭平菊;61例多原發(fā)癌的病種分布和預(yù)后分析[J];第四軍醫(yī)大學(xué)學(xué)報(bào);2002年01期

3 陳伊寧,宋斌,溫文勝;復(fù)發(fā)性喉癌42例臨床分析[J];廣西醫(yī)科大學(xué)學(xué)報(bào);2003年03期

4 劉業(yè)海,唐平章,徐震綱,祁永發(fā);聲門型喉癌部分喉切除術(shù)后復(fù)發(fā)原因探討及預(yù)防[J];臨床耳鼻咽喉科雜志;2003年03期

5 王全桂,趙偉;聲門型喉癌術(shù)后復(fù)發(fā)與轉(zhuǎn)移的初步分析[J];臨床耳鼻咽喉科雜志;2003年09期

6 周梁,丁彭,王薇;喉癌術(shù)后局部復(fù)發(fā)與手術(shù)切緣的關(guān)系[J];臨床耳鼻咽喉科雜志;2004年06期

7 于剛,潘子民,李紅;喉癌患者喉部第二原發(fā)癌一例[J];中華耳鼻咽喉科雜志;2001年04期

8 黃志剛,韓德民,于振坤,倪鑫,葛秀明;CO_2激光手術(shù)治療聲門型喉癌療效分析[J];中華耳鼻咽喉科雜志;2002年03期

9 丁彭,周梁,王紓宜;局部復(fù)發(fā)喉癌的發(fā)生學(xué)研究[J];中華耳鼻咽喉頭頸外科雜志;2005年08期

10 伍國(guó)號(hào),陳福進(jìn),曾宗淵,李浩,林國(guó)武,宋明,魏茂文,許光普,楊安奎,陳文寬;放射誘發(fā)的第二原發(fā)性惡性腫瘤的臨床治療[J];中華腫瘤雜志;2003年03期

，

本文編號(hào)：1525297