A Clinical Study On Detection And Therapy Of Cervical Lymph Node Metastasis In The Patients With Superglottic Carcinoma

Objective: To investigate the methods of diagnosis and therapy of cervical lymph node metastasis in the patients with superglottic carcinoma.Methods: 61 patients with superglottic carcinoma were divided into three groups by 1997 UICC TNM. N0 1 group: 17 cases, in which the cervical lymph nodes positive and the largest nodal diameters than 10 millimeters. No 2 group: 21 cases, in which the cervical lymph nodes are positive or negative, but the largest nodal diameters are larger than 10 millimeters in CT. No 3 group: 23 cases in which the cervical lymph nodes are negative in PE, and the largest nodal diameters are smaller than 10 millimeters in CT.The different neck dissections were performed on the patients in which the cervical lymph nodes are negative in PE. In order to define the range of dissection, the sentinel lymph nodes are detected by injecting dye during operation.According to the postoperative histopathological results and the postoperative cervical lymph nodal situation in respectively one year and three years, analyse the significance of the diagnosis and effects of the neck dissections in those patients.Results: No 1 group of 17 cases, 10 cases, in which cervical lymphnodes were found to be positive in the routine histopathology. The metastasis rate was 58.8%, 3 cases were bilateral metastases. The positive lymph nodes were mainly located in the level II, HI and IV regians. There is no positive lymph node in the level V. No 2 group of 21 cases, 8 cases are positive, the metastasis rate was 38.1%, one cases is bilateral metastasis, the positive lymph nodes were located in the level II and HI. There is no positive lymph node in the levels IV and V. No 3 groups 69.6% patients were successfully dectected the sentinel lymph nodes during operations but only one cases was found to be positive in the frozen in spection during operations, 3 cases were found to be positive by means of the successive histotomy, of lymph nodes, the metastasis rate is 13.0% no one is hilateral, the lymph nodes were located in level II regine, the range of dissection was involved with the positive lymph nodes and the next station of the nodes. The postoperative recurrent rates are respectively 16.3% and 26.2% in one year and three year. The recurrent rates are significant by case-control study.Conclusion: Combining PE and CT may assist the diagnosis of cerveical lymph nodal metastasis. Defining the minimal nodal diameter as the diagnosis threshold of lymph nodal metastasis in CNo is rational in clinical work. The sentinel lymph nodes by infecting dye may be mostly indicated, during operation, but the postitive rate is less in the frozen inspection during operation. The patients with superglottic carcinoma, whose cervical lymph node is negatine in PE but is positive in CT, may be performed bilateral selective neck dissection, the effect of the operation is satisfying. The effect of therapy with Chinese Traditionaldrugs isn't significant in the study.