原发于喉部的非鳞状细胞癌11例并文献复习

doi:10.6040/j.issn.1673-3770.0.2014.302

摘要/Abstract

摘要： 目的探讨除鳞状细胞癌外其他特殊病理类型的喉恶性肿瘤的临床表现及病理特点,提高其诊断和治疗水平。方法回顾性分析366例原发性喉恶性肿瘤中11例非鳞状细胞癌患者的临床资料,采用HE染色和免疫组化法,观察其组织病理学改变及免疫表型,并复习有关文献。结果 11例中腺癌2例,腺样囊性癌1例,恶性淋巴瘤2例,神经内分泌癌1例,肉瘤样癌5例。其中声门区病变5例,声门上区病变4例,声门下区病变2例。均经活检或手术病理证实,活检 1 次即明确诊断者仅 2 例,其余病例经多次重复活检甚至最后手术切除方才确诊。确诊前的诊断多为慢性炎症、炎性息肉、增生性改变、坏死性肉芽肿、鳞癌等,除1例恶性淋巴瘤未行手术外,其余病例均首选手术治疗,部分联合放射治疗和(或)化学治疗。死亡2例,失访3例,其他患者均存活至今。结论该病的临床表现缺乏特征性,检查所见肿物形态不一,与常见的良、恶性喉肿瘤不易鉴别,病理检查、免疫组化检查有助于确诊,临床上应根据组织病理学特点选用手术切除、放射治疗、化学治疗或综合性治疗。

关键词: 综合性治疗, 非鳞状细胞癌, 喉肿瘤

Abstract: Objective To explore the clinical and pathological features of laryngeal non-squamous cell carcinoma to improve diagnosis and treatment. Method The clinical data of 11 non-squamous cell carcinoma cases, selected from 366 cases of primary malignant tumor of larynx, were reviewed. Results All the patients came from the E.N.T department of the Affiliated Drum-Tower Hospital of Nanjing University Medical School from Jan. 2000 to Dec. 2009. The histopathology and immunophenotype were observed by HE staining and immunohistochemistry, including 2 adenocarcinoma, 1 adenoid cystic carcinoma, 2 malignant lymphoma, 1 neuroendocrine carcinoma, and 5 sarcomatoid carcinoma. Among them, the tumor located in glottic (5 cases), supraglottic (4 cases) and infraglottic regions (2 cases). All cases were confirmed by biopsy or pathologic studies after operation. Except for 2 single biopsy, other cases were diagnosed by repeated biopsy or operation. Most pathological results were chronic inflammation, inflammatory polyps, hyperplastic change, necrotic granuloma, squamous cell carcinoma and so on. All the patients underwent primary surgery except for one malignant lymphoma. Some received consecutive radiotherapy and/or chemotherapy. During the follow up, 2 cases died, 3 cases lost, and others survived. Conclusion The clinical manifestations of primary laryngeal non-squamous cell carcinoma are indefinite. It is not easy to identify it with the common laryngeal tumors. Pathological study and immunohistochemistry are helpful for diagnosis. The choice of management (surgery, radiotherapy, chemotherapy or combined) depends on pathological diagnosis.

Key words: Laryngeal tumor, Non-squamous cell carcinoma, Combined therapy

中图分类号:

R739.65

王玉红, 王倩, 陈萍, 钱晓云. 原发于喉部的非鳞状细胞癌11例并文献复习[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 83-88.

WANG Yu-hong, WANG Qian, CHEN Ping, QIAN Xiao-yun. Clinical analysis of primary laryngeal non-squamous cell carcinoma (11 cases report)[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(1): 83-88.

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