协和医学杂志

2012, v.3(02) 170-174

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喉部肉瘤的临床病理特征及预后
Clinical and Pathological Characteristics and Treatment Outcome of Sarcoma of the Larynx

金晓峰;陈兴明;李五一;彭培宏;姜鸿;祝小莉;曹克利;张宝泉;张连山;高志强;
JIN Xiao-feng,CHEN Xing-ming,LI Wu-yi,PENG Pei-hong,JIANG Hong,ZHU Xiao-li,CAO Ke-li,ZHANG Bao-quan,ZHANG Lian-shan,GAO Zhi-qiang Department of Otorhinolaryngology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

摘要(Abstract):

目的探讨喉部肉瘤的临床病理特征及其预后影响因素。方法回顾性分析北京协和医院耳鼻咽喉科1990年1月至2008年12月期间住院治疗的13例喉部肉瘤患者的临床资料,分析肿瘤的临床病理特性,以Kaplan-Meier法进行生存率统计并分析临床分期和组织学分级与生存率的关系。结果喉部肉瘤患者以男性为主(9/13),含7种病理类型:恶性纤维组织细胞瘤、平滑肌肉瘤、横纹肌肉瘤、滑膜肉瘤、软骨肉瘤、神经纤维肉瘤、癌肉瘤。12例接受手术治疗,其中7例术后进行了放疗和/或化疗;另1例仅行放疗。全部病例平均随访29.3个月,其中5例出现局部复发,1例出现远处转移,5年生存率为38.0%。临床分期和组织学分级对生存率有明显影响(P<0.05)。结论喉部肉瘤预后差,临床分期和组织学分级与预后相关。
Objective To determine the clinical and pathological characteristics as well as outcome of sarcoma of the larynx.Methods A retrospective review of 13 patients with laryngeal sarcoma treated in Peking Union Medical College Hospital from January 1990 to December 2008 was taken to identify clinical characteristics,pathological characteristics,and therapeutic modalities.Kaplan-Meier survivals were compared according to T-stage and histological G-grade.Results Sarcoma of the larynx showed a male predominance in all cases (9/13) and presented 7 pathological types:maglignant fibrous histiocytoma,leiomyosarcoma,rhabdomyosarcoma,synovial sarcoma,chondrosarcoma,neurofibrosarcoma,carcinosarcoma.Twelve cases underwent tumor resection,including partial laryngectomy,total laryngectomy,and endoscopic resection.Among them,7 cases underwent postoperative radiological therapy and/or chemical therapy.Another case only received radiological therapy.The average follow up time of all cases was 29.3 months and five-year survival rate was 38.0%.Local recurrence occurred in 5 cases and distant metastasis in 1 case.Survival rate was significantly different according to T-stage and histological G-grade (log-rank,P<0.05).Conclusions Sarcomas of the larynx show poor prognosis.The factors influencing survival rate include T-stage and G-grade.

关键词(KeyWords): 喉肿瘤;肉瘤;预后;喉切除术
laryngeal neoplasms;sarcoma;prognosis;laryngectomy

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作者(Author): 金晓峰;陈兴明;李五一;彭培宏;姜鸿;祝小莉;曹克利;张宝泉;张连山;高志强;
JIN Xiao-feng,CHEN Xing-ming,LI Wu-yi,PENG Pei-hong,JIANG Hong,ZHU Xiao-li,CAO Ke-li,ZHANG Bao-quan,ZHANG Lian-shan,GAO Zhi-qiang Department of Otorhinolaryngology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

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