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

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] 刘佳珲,田汝宪,李玉梅,宋西成. 构建铜死亡相关lncRNA模型评估头颈鳞状细胞癌预后[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 49-64.
[2] 盘琳琳,万佳明,李越,何龙. 自噬相关LncRNA是头颈部鳞状细胞癌的预后指标[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 97-107.
[3] 胡祎,孔旭辉. 补体在喉鳞状细胞癌发生发展中作用机制的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 148-155.
[4] 沈文浩,陈曦. 双能CT在喉鳞状细胞癌诊疗中的运用[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 156-160.
[5] 杨鸣,刘雪霞,张华. m6A识别蛋白IGF2BPs家族在头颈肿瘤中的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 153-161.
[6] 黄佳丽,刘梓琪,徐娟,陈曦,张立庆,周涵. 咽部梭形细胞鳞状细胞癌的临床及预后分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 94-100.
[7] 周诗侗,杨艳艳,杨玉成,方红雁. 胃蛋白酶与咽喉反流性疾病:从致病机制到咽喉鳞状细胞癌的潜在风险因素[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 55-60.
[8] 吴彬,周敬淳. 单细胞测序分析喉鳞状细胞癌细胞RPN2表达模式[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 1-11.
[9] 王凯健,陈雪生,王威. 血小板-淋巴细胞比值与喉鳞状细胞癌预后相关性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 67-73.
[10] 宋斐,宋昊,李玉梅,牟亚魁,宋西成. 肿瘤源性外泌体在头颈鳞状细胞癌微环境中的免疫调节作用[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 92-100.
[11] 张永红,张辉,王彩华,杨欣欣,吴允刚,赵玉凤,庞太忠,李晓瑜. 基于TCGA数据库构建喉鳞状细胞癌免疫相关基因预后模型及筛选靶向分子药物[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 54-62.
[12] 周一静,邹建银,易红良,吴红敏. TGFBI在头颈部鳞状细胞癌中的表达及其临床意义[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 85-95.
[13] 文锋,张驰,扈希昊,董冰婉,秦永,赵恩民. 喉部腺样囊性癌4例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 119-125.
[14] 杨英玲,苟浩铖,冯俊. 细胞焦亡的分子机制及其在头颈部鳞状细胞癌中的研究现状[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 160-165.
[15] 李亚楠,梁辉. 人乳头瘤病毒相关口咽鳞状细胞癌发生机制的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 104-110.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!