Clinical And Pathological Analysis Of Cervical Lymph Node Metastasis In Laryngeal Cancer

Objective: 1. Retrospective analysis of laryngeal cancer with neck lymph node metastasis by tumor primary site, T phases, and the degree of tumor differentiation 2. Summing up the relationship between neck lymph node metastasis of laryngeal cancer and pre-operative type B ultrasmnogrphy and CT / MRI scanning.Methods: Retrospective analysis of 66 patient's clinical data of laryngeal cancer with cervical lymph node metastasis in the first affiliated hospital of Guangxi Medical University from Jan.2006 to Dec.2008Results: (1) The high prevalence rate of laryngeal cancer was 40 to 60-year-old about 55%.( 2) The pathological types in this group: squamous cell carcinoma was 65 cases, accounting for 98.48% (65/66); one cases of adenocarcinoma, accounting for 1.51% (1 / 66). (3)66 cases of laryngeal cancer patients, 47 routine bilateral neck lymph node dissection, 19 routine lesion side (unilateral) neck lymph node dissection. Among them, 22 cases lymph node metastasis confirmed by pathologically, the transfer rate was 33.33% (22/66). The transfer rate of laryngeal cancer: preoperative examination (including the mages) was 48.48% (32/66), both analysised by statistics P> 0.05, no significant difference. (4) The cervical lymph node metastasis rates of laryngeal cancer in primary site were as follows: supraglottic 76.47% (13/17), glottic 11.62% (5 / 43), subglottic 66.67% (4 / 6). By statistical analysis P <0.05, had significant difference, the rate of supraglottic and subglottic cervical lymph node metastasis higher. (5) The neck lymph node metastasis rates of T staging in laryngeal cancer were: TI 14.28% (1 / 7), T2 16.66% (3 / 18), T3 42.30% (11/26), T4 46.67% (7 / 15). There was no significant difference (P> 0.05); Tl + T2 cervical lymph node metastasis rate was 16.00% (4 / 25), T3 + T4 was 43.90% (18/41).there was a significant difference (P <0.05). (6) Differentiation laryngeal cancer and neck lymph node metastasis rates were: poorly differentiated squamous cell carcinoma was 60% (3 / 5), mid-differentiation was 35.00% (14 / 40), well-differentiated was 20.00% (4 / 20). There was a significant difference between well-differentiated squamous cell carcinoma and poorly differentiated (P <0.05), the differentiation of well and medium,medium and poorly no significant difference (P> 0.05). (7) Preoperative neck B type ultrasonography were 29 cases of suspicious lymph node metastasis, postoperative pathological examination confirmed that there were 22 cases of transfer; There was no significant difference (P> 0.05). (8) Preoperative neck CT / MRI examination were 27 cases of suspicious lymph node metastasis, postoperative pathological examination confirmed that there were 22 cases of transfer; there was no significant difference (P> 0.05).Conclusion: (1) the rate of cervical lymph node metastasis between preoperative laryngeal cancer and postoperative pathological examination confirmed showed no significant difference in this group.(2) the rate of cervical lymph node metastasis in supraglottic and subglottic laryngeal cancer was higher, glottic was lower (3) the rate of cervical lymph node metastasis in T3 + T4 period was higher than T1 + T2 period (4) the differentiation of laryngeal cancer in relation to cervical lymph node metastasis, poorly differentiated squamous cell carcinoma cervical lymph node metastasis was significantly higher than well-differentiated (5) the preoperative type B ultrasmnogrghy and CT / MRI examinations were conducive to the neck lymph node metastasis in preoperative diagnosis, contribute to draw up the plan of neck lymph node dissection mode. But a comprehensive analysis of combining history pre-operation was required.