| Objective: Prelaryngeal lymph node metastasis as an important indicator of poor prognosis of laryngeal cancer has been widely proposed,this paper through retrospective analysis of different glottic carcinoma prelaryngeal lymph node metastasis,in order to provide basic information for normalizing laryngocarcinoma surgery.Methods: In 92 cases of glottic cancer the First Affiliated Hospital of Medical University Of Anhui from January 2005 to June 2014 were retrospectively analyzed,including male 90 patients,female 2 patients,aged between 42-77 years old,the average age is 56.8 years old.Of the 92 cases with glottic carcinoma at different time of surgery,all underwent prelaryngeal lymph node dissection,collected effective prelaryngeal lymph.The differences of tumor staging,pathological typing,comprehensive or local postoperative recurrence of cervical lymph node,survival rateafter 3 and 5 years are compared and analyzed between the groups of positive and negative prelaryngeal node.Results: There were 5 cases(5.4%)of positive prelaryngeal node among total 92 cases,all the 5 patients with positive lymph nodes were T3 lesions.This group of early laryngeal cancer(stage I and II)no prelaryngeal lymph node metastases,and in advanced laryngeal cancer(stage III and IV)prelaryngeal lymph node metastasis rate was 15.2%(5/33),chi square =6.73,P<0.01.The prelaryngeal nodes of advanced laryngocarcinoma(III,IV stage)is more easily to metastasize then those of early stages(I,II),P<0.01,the differences are statistically significant.The pathology of laryngeal squamous cell carcinoma in 92 cases: 41 cases of high differentiation,differentiation in 40 cases,11 cases of low differentiated;with prelaryngeal lymph node metastasis of differentiated squamous cell carcinoma in 2 cases,accounting for 4.88%(2/41),middle and low differentiation 3 cases,accounted for 5.88%(3/51),Chi square =0.06,p>0.05,difference no statistical significance,so the prelaryngeal lymph node metastasis and pathological type showed no significant difference.No prelaryngeal lymph node metastasis in laryngeal carcinoma is the prelaryngeal lymph node negative group after cervical cervical lymph node metastasis occurred in 2.30%(2/87),and the prelaryngeal lymph node metastasis in laryngeal carcinoma is the prelaryngeal lymph node positive group postoperative cervical lymph node metastasis was 40%(2/5),a high negative,chi square(=8.37 p <0.01),so the prelaryngeal lymph node metastasis positive group postoperative cervical lymph node metastasis was higher than the negative group,the difference was statistically significant.No prelaryngeal lymph node metastasis in laryngeal carcinoma is the prelaryngeal lymph node negative group postoperative local recurrence was 12.6%(11/87),and the prelaryngeal lymph node metastasis in laryngeal carcinoma is the prelaryngeal lymph node positive group postoperative local recurrence accounted for 60%(3/5),is higher than that of the former,chi square =4.96,(0.01<p<0.05),so the prelaryngeal lymph node the positive transfer of postoperative local recurrence was higher than the negative group,the difference was statistically significant.There were 5 cases with positive lymph nodes before the larynx,with an average survival time of 31.33 months,standard error of months,95%CI:19.04 months to 43.62 months,the median survival time was 19 months.87 cases of prelaryngeal lymph node negative patients,the average survival time of 51.97 months,the standard error of 1.76 months,95%CI:48.52 months to 55.43 months,the median survival time was 60 months,chi square =21.36,p<0.01,the prelaryngeal lymph node negative group than in positive group survival time,the difference was statistically significant.Conclusion: Prelaryngeal lymph node metastasis rate was higher in late glottic carcinoma,for advanced laryngeal cancer should be routinely prelaryngeal lymph node dissection;prelaryngeal lymph node metastasis,increase the chance of neck and local recurrence of poor prognosis associated with prelaryngeal lymph node metastasis in advanced laryngeal cancer surgery should be based on the specifications after the operation,attaches great importance to treatment. |
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