CAJ | 학술논문

背景与目的:下咽癌早期即可出现区域淋巴结转移,然而关于下咽癌区域淋巴结尤其是咽后淋巴结转移的报道少见.本研究旨在通过对下咽癌CT/MRI扫描结果的分析,探讨下咽癌区域淋巴结特别是咽后淋巴结转移的特性,为临床治疗提供参考.方法:回顾性分析2000年8月至2009年3月我院病理证实的88例下咽癌区域淋巴结转移的CT/MBI结果.对其局部分期、各区域淋巴结转移的相互关系采用χ~2检验和Logistic多因素分析研究.结果:下咽癌的区域淋巴结转移率为73.9%,Ⅱa、Ⅱb、Ⅲ区淋巴结转移发生率最高,分别为61.4%、44.3%及37.5%.Ⅰ、Ⅳ、Ⅴ、Ⅵ区及咽后淋巴结转移都较少,并且均合并Ⅱ、Ⅲ区淋巴结转移.单因素分析显示1 b、Ⅲ区淋巴结转移与Ⅳ区淋巴结转移.Ⅱb区、双侧颈部淋巴结转移与咽后淋巴结转移的关系有统计学意义.多因素分析结果显示Ⅳ区淋巴结转移与Ⅵ区淋巴结转移,双侧颈部淋巴结转移与咽后淋巴结转移的关系有统计学意义.结论:下咽癌区域淋巴结转移途径遵循一定的规律,跳跃性转移少见,以Ⅱ、Ⅲ区转移最常见.双侧颈部淋巴结可能是咽后淋巴结转移的危险因素.
배경여목적:하인암조기즉가출현구역림파결전이,연이관우하인암구역림파결우기시인후림파결전이적보도소견.본연구지재통과대하인암CT/MRI소묘결과적분석,탐토하인암구역림파결특별시인후림파결전이적특성,위림상치료제공삼고.방법:회고성분석2000년8월지2009년3월아원병리증실적88례하인암구역림파결전이적CT/MBI결과.대기국부분기、각구역림파결전이적상호관계채용χ~2검험화Logistic다인소분석연구.결과:하인암적구역림파결전이솔위73.9%,Ⅱa、Ⅱb、Ⅲ구림파결전이발생솔최고,분별위61.4%、44.3%급37.5%.Ⅰ、Ⅳ、Ⅴ、Ⅵ구급인후림파결전이도교소,병차균합병Ⅱ、Ⅲ구림파결전이.단인소분석현시1 b、Ⅲ구림파결전이여Ⅳ구림파결전이.Ⅱb구、쌍측경부림파결전이여인후림파결전이적관계유통계학의의.다인소분석결과현시Ⅳ구림파결전이여Ⅵ구림파결전이,쌍측경부림파결전이여인후림파결전이적관계유통계학의의.결론:하인암구역림파결전이도경준순일정적규률,도약성전이소견,이Ⅱ、Ⅲ구전이최상견.쌍측경부림파결가능시인후림파결전이적위험인소.
Background and Objective:Hypopharyngeal carcinoma has a high risk for early regional lymphatic dissemination.However.reports about regional lymph node metastases, especially retropharyngeal lymph node metastases,are rare.This research explored the spread of hypopharyngeal carcinoma, especially metastases of the retropharyngeal lymph nodes by studying computed tomography(CT) and magnetic resonance imaging (MRI) images. Methlods:The CT/MRI images of 88 patients with pathologically confirmed hypOpharyngeaI carcinomas that were performed at our hospital between August 2000 and March 2009 were analyzed retrospectively.The interrelations among local stage and lymph nodes in vanous regtons were analyzed by χ~2 test and multivariate logistical regression. ResulIts:The rate of regional lymph node metastasis for all patients was 73.9%.and the highest rates of positive lymph nodes were at levels 11 a(61.4%),11 b(44.3%),and Ⅲ (37.5%).Metastases to levels Ⅰ,Ⅳ,Ⅴ,and Ⅵ were rare,as were retropharyngeal lymph-node metastases,which were always combined with metastases at levels Ⅱ and Ⅲ.Univariate analysis showed that level-Ⅳ metastases correlated to metastases at levels Ⅰ b and Ⅲ:retropharyngeal lymph node metastases were correlated to level Ⅱ b and bilateral cervical lymph node metastases. Multivariate analysis showed that level-Vl metastases correlated to level Ⅳ and that retropharyngeal lymph-node metastases correlated to bilateral cervical lymph node metastases.Conclusions:Regional lymph node metastases in patients with hypopharyngeal carcinoma follow some regulations,and skip metastasis is rare.The highest rates of positive lymph nodes are at levels Ⅱ and Ⅲ.Bilateral lymph node metastases may be a risk factor for retropharyngeallymph node metastases.