【摘要】：目的總結(jié)T2~T4喉癌頸淋巴結(jié)轉(zhuǎn)移規(guī)律,并分析其相關(guān)因素,探討T2~T4喉癌頸淋巴結(jié)處理規(guī)范。方法回顧2002-12-16-2013-01-07首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院401例行喉部開放性手術(shù)治療的T2~T4NXM0喉癌患者,應(yīng)用Logistic回歸分析喉癌淋巴結(jié)轉(zhuǎn)移相關(guān)因素,Cox回歸分析喉癌死亡危險(xiǎn)因素,研究其頸淋巴結(jié)轉(zhuǎn)移規(guī)律及相關(guān)因素。結(jié)果本組中晚期喉癌頸淋巴結(jié)總體轉(zhuǎn)移24.4%(98/401)。Logistic回歸分析結(jié)果提示,T分級(jí)(P=0.014)、喉癌分型(P=0.001)及病理(P=0.009)分級(jí)是喉癌淋巴結(jié)轉(zhuǎn)移的相關(guān)因素,Ⅱ、Ⅲ、Ⅳ和ⅡB區(qū)的隱性轉(zhuǎn)移率分別為17.2%(69/401)、16.7%(67/401)、2.5%(10/401)和1.5%(6/401)。全組1、3和5年生存率分別為98%、83%和79%。Cox回歸分析發(fā)現(xiàn),淋巴結(jié)轉(zhuǎn)移(P0.001)與T分級(jí)(P=0.001)是喉癌死亡的危險(xiǎn)因素,而喉癌分型對(duì)于喉癌預(yù)后影響差異無統(tǒng)計(jì)學(xué)意義。結(jié)論喉癌頸部淋巴結(jié)轉(zhuǎn)移的發(fā)生與腫瘤的分型、T分級(jí)有關(guān),不同分型喉癌的頸淋巴結(jié)轉(zhuǎn)移區(qū)域有一定規(guī)律性,頸淋巴結(jié)轉(zhuǎn)移是導(dǎo)致喉癌死亡的重要因素之一,應(yīng)根據(jù)喉癌的不同分型和T分級(jí)處理頸淋巴結(jié)。
[Abstract]:Objective to summarize the law of cervical lymph node metastasis in T2~T4 laryngeal carcinoma and analyze its related factors and discuss the management criteria of cervical lymph node in T2~T4 laryngeal carcinoma. Methods T2~T4NXM0 laryngeal cancer patients who were treated with open laryngeal surgery at Tongren Hospital affiliated to Capital Medical University from December 2002 to July 2013-01-07 were retrospectively reviewed. Logistic regression analysis was used to analyze the risk factors associated with lymph node metastasis of laryngeal carcinoma and the risk factors of laryngeal cancer death. To study the law of cervical lymph node metastasis and related factors. Results the results of logistic regression analysis showed that T grade (P0. 014), laryngeal carcinoma classification (P0. 001) and pathological grade (P0. 009) were related factors of lymph node metastasis. The recessive metastasis rates of 鈪，

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