山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (5): 98-100.doi: 10.6040/j.issn.1673-3770.0.2015.426

• 论著 • 上一篇    下一篇

CO2激光治疗声门型喉癌远期疗效分析

马玲国,郑朝攀,周敬淳,张博,龚桃根,张云静   

  1. 深圳市人民医院/暨南大学第二附属医院耳鼻咽喉头颈外科, 广东 深圳 518020
  • 收稿日期:2015-10-15 出版日期:2016-10-20 发布日期:2016-10-20
  • 作者简介:马玲国. E-mail:ljymax@163.com

Long-term curative effect of CO2 laser surgery for glottic laryngeal carcinoma.

MA Lingguo, ZHENG Chaopan, ZHOU Jingchun, ZHANG Bo, GONG Taogen, ZHANG Yunjing   

  1. Department of Otolaryngology &Head and Neck Surgery, Shenzhen Peoples Hospital / Second Clinical College of Jinan University, Shenzhen 518020, Guangdong, China
  • Received:2015-10-15 Online:2016-10-20 Published:2016-10-20

HTML

PDF (PC)

616

摘要： 目的 探讨显微支撑喉镜下CO2激光治疗声门型喉癌的远期治疗效果。 方法 对声门型喉癌患者106例,采用显微支撑喉镜下CO2激光治疗,回顾性分析病历资料。其中TisN0M0 4例、T1aN0M0 62例、T1bN0M0 16例、T2N0M0 22例、T3N0M0 2例。 结果 106例患者手术顺利,无严重并发症发生。术后死于复发或颈部转移4例,死于意外4例,死于远处转移2例,失访4例,术后局部复发者再次手术后至今良好2例。目前92例仍存活,无肿瘤复发,生活质量良好。3年、5年和10年生存率分别为98.7%、95.2%和89.0%,总局部复发率为5.7%。 结论 显微支撑喉镜下CO2激光手术是治疗Tis、T1a声门型喉癌的首选方法,手术创伤小,术后恢复快,喉功能保全好,远期生存率高;该手术对于经过精心选择的声门型T1b和T2、T3喉癌也有较好的临床疗效。

关键词: 喉肿瘤, 声门型喉癌, 支撑喉镜, CO2激光, 鳞状细胞癌

Abstract: Objective To evaluate the long-term curative effect of CO2 laser surgery for glottic laryngeal carcinoma under microscopic suspension laryngoscope. Methods Clinical data of 106 cases of glottic laryngeal carcinoma were retrospectively analyzed, including 4 cases of TisN0M0, 62 cases of T1aN0M0, 16 cases of T1bN0M0, 22 cases of T2N0M0, and 2 cases of T3N0M0. All cases were treated with microscopic suspension laryngoscope CO2 laser surgery during 2004 and 2015. Results All operations were successful without serious complications. Of all 106 cases, 4 died of recurrence, 4 died of accidents, 2 died of distant metastases, 4 failed to be followed up, and 2 received a second operation due to recurrence and survived well. A total 92 patients were still alive without recurrence, with good quality of life. The 3, 5 and 10-year survival rate were respectively 98.7%, 95.2% and 89.0%. The local recurrence rate was 5.7%. Conclusion Microscopic suspension laryngoscope CO2 laser surgery is the preferred method for glottic laryngeal carcinoma Tis and T1a, which produces few surgical trauma, fast postoperative recovery, good laryngeal function preservation and high long-term survival rate. This operation method also has good clinical effect for selected cases of glottic laryngeal carcinoma T1b, T2 and T3.

Key words: Larynx neoplasm, Glottic cancer, Squamous-cell carcinoma, CO2 laser, Suspension laryngoscope

中图分类号: 

  • R739.65
[1] Hartl D M, de Mones E, Hans S, et al. Treatment of early stage glottic cancer by transoral laser resection[J]. Ann Otol Rhinol Laryngol, 2007, 116(11):832-836.
[2] Mota G, Esposito E, Motta S, et al. CO2 laser surgery in the treatment of glottic cancer[J]. Head Neck, 2005, 27(7):566-573.
[3] Bumber Z, Prgomet D, Janjanin S. Endoscopic CO2 laser surgery for supraglottic cancer—ten years of experience[J]. Coll Antropol, 2009, 33(1):87-91.
[4] Remacle M, Eckel H E, Antonelli A, et al. Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society 2000[J]. Eur Arch Otorhinolaryngol, 2000, 257(4):227-231.
[5] 王颖, 周佳青. CO2激光治疗早期声门型喉癌的研究进展[J]. 现代肿瘤医学, 2012, 20(7):1483-1486. WANG Ying, ZHOU Jiaqing. The progress of CO2 laser surgery in the early glottic cancer[J]. Modern Oncology, 2012, 20(7):1483-1486.
[6] 黄志刚, 韩德民, 于振坤, 等. 支撑喉镜下CO2激光喉部分切除最大范围的实验研究[J]. 中华耳鼻咽喉科杂志, 2004, 39(7):399-401. HUANG Zhigang, HAN Demin, YU Zhenkun, et al. Largest extension of laser surgery for laryngeal cancer in experimental animals[J]. Chin J Otorhinolaryngol, 2004, 39(7):399-401.
[7] Ledda G P, Puxeddu R. Carbon dioxide laser microsurgery for early glottic arcinoma[J]. Otolaryngol Head Neck Surg, 2006, 134(6):911-915.
[8] 胡艳红, 王东海, 李翔宇, 等. 早期声门型喉癌CO2激光术后复发相关因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(22):1774-1776. HU Yanhong, WANG Donghai, LI Xiangyu, et al. Evaluate the related factors of recurrence after carbon dioxide laser in treatment of early glottic carcinoma[J]. Clin J Otorhinolarynol Head Neck Surg, 2014, 28(22):1774-1776.
[9] 何发尧, 王跃建, 陈伟雄, 等. 早期声门型喉癌的CO2激光手术治疗[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(3):493-495. HE Fayao, WANG Yuejian, CHEN Weixiong, et al. Clinical research of early laryngocarcinoma treatment by carbon dioxide laser microsurgery[J]. Clin J Otorhinolarynol Head Neck Surg, 2014, 28(7):493-495.
[10] 王颖, 周佳青. CO2激光治疗早期声门型喉癌的Meta分析[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(18):783-792. WANG Ying, ZHOU Jiaqing. Local recurrence of CO2 laser surgery for patients with early glottic carcinoma: a systematic review and meta-analysis[J]. Clin J Otorhinolarynol Head Neck Surg, 2012, 26(18):783-792.
[11] 黄志刚, 韩德民, 于振坤, 等. CO2激光手术治疗声门型喉癌疗效分析[J]. 中华耳鼻咽喉科杂志, 2002, 37(3):219-222. HUANG Zhigang, HAN Demin, YU Zhenkun, et al. Evaluate the curative effect of CO2 laser in treatment of glottic carcinoma[J]. Chin J Otorhinolarynol, 2002, 37(3):219-222.
[1] 吴静,刘业海. 头颈部鳞状细胞癌的靶向治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 97-102.
[2] 许雯,汤玮,余少卿,李少辉,葛荣明. 平阳霉素治疗咽喉部血管瘤[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 62-64.
[3] 蓝云英,阳宇,李鸿. 鳃裂癌一例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 112-114.
[4] 李俏丽,李超,王薇,蔡永聪,孙荣昊,周雨秋,税春燕, 黄璐,涂静. 术后放化疗后复发并侵及侧颅底的原发性腮腺鳞状细胞癌一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 87-88.
[5] 郝艳,李栋才,蓝建平. CO2激光显微手术与传统显微手术切除声带息肉疗效比较[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 68-70.
[6] 付玉贵,王海兰,孙德重,杨佩珍,陈彦林,陈志鹏. 保留部分环状软骨环的喉全切除术[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 73-75.
[7] 张明德,张祖平,于学民,魏燕红,袁英. RASSF2A基因甲基化在喉癌组织中的表达及意义[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 64-67.
[8] 朱晓城,钱晓云,顾亚军,沈晓辉,宋盼盼,李惠,高下. MGMT和EGFR蛋白在喉鳞状细胞癌中的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 68-72.
[9] 安永明,穆文利,田艳勋,李伟,吴彦桥. 喉鳞癌组织中抑癌基因Maspin和转录因子Ets1的表达及意义[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 91-94.
[10] 薛建军. CO2激光治疗舌根部肿物18例[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 61-62.
[11] 贾岩峰,杨春伟,宋富春,杨相立,王林,刘吉祥. CO2激光联合质子泵抑制剂治疗复发性声带突肉芽肿的疗效观察[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 106-109.
[12] 包伟晶,宁佳羽,朱忠寿,魏日富,林昶. CO2激光切除累及前联合的早期声门癌26例[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 101-105.
[13] 王晓燕,郑燕青,郑昊,叶青. 脉冲CO2激光与Er:YAG激光中耳骨消融的实验研究[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 75-79.
[14] 苏甜甜,张佳综述,孙臻峰审校. 多药耐药基因蛋白P-gp和ABCG2在喉癌等头颈肿瘤中的作用及相关信号通路[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 103-106.
[15] 董频,英信江,陈歆维,邓志宏,张少强,於子卫,金斌,孙臻峰,谢晋,祝江才. 新辅助化疗方案尼妥珠单抗联合奈达铂和5-氟尿嘧啶治疗下咽鳞癌初步临床分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 10-14.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发