中文摘要：

目的 探讨声门上型喉癌颈淋巴转移灶诊断及治疗对策。方法 对我科2000—08-2003—03收治的声门上型喉癌61例，按1997 UICC TNM分类及分期进行诊断，其中CN0的诊断标准定义为体格检查（PE）阴性，且CT所见淋巴结最大轴径〈10mm。将所有病例分为三组：Ⅰ组PE及CT均为阳性的CN1病例及全部CN2—3病例；Ⅱ组PE阴性、CT为阳性的CN，病例；Ⅲ组PE阴性，CT所见淋巴结最大轴径〈10mm的CN0病例，分别选择不同范围的颈淋巴结清扫术。CN0病例术中行前哨淋巴结（SN）检测，确定清扫范围，据术后病理及3年、5年颈部控制率评价颈部转移癌疗效。结果Ⅰ组病例17例，颈转移率58．8％，淋巴转移分布于Ⅱ-Ⅳ区；Ⅱ组病例21例，颈转移率38．1％，分布于Ⅱ-Ⅲ区；Ⅲ组病例23例，行SN检测，成功率69．6％，术中冰冻阳性1例，术后连续切片观察阳性转移3例，颈转移率13．0％，分布于Ⅱ区淋巴结。行不同区域颈淋巴结清扫术，其中3年颈部复发率16．3％，5年颈部复发率26．2％。与不同时期声门上型喉癌临床资料为对照，统计学处理有明显差异。结论　CN0病例影像学指标淋巴结最大轴径〈10mm可合理指导临床，术中SN检测可指导颈清扫范围。CN0及CN1病例可行双侧分区性颈清扫术替代传统术式，疗效满意。

英文摘要：

Objective To explore the methods of diagnosing and treating cervical lymphatic metastasis in patients with superglottic carcinoma. Methods Sixty-one patients with superglottic carcinoma were divided into 3 groups by 1997 UICC TNM. In group Ⅰ the cervical lymph nodes of 17 cases were positive in both CT and PE, with the largest nodal diameters than 10 millimeters. In group Ⅱ ,lymph nodes of 21 cases were positive in CT and negative in PE, with the largest nodal diameters larger than 10 millimeters in CT. In group Ⅲ the cervical lymph nodes of 23 cases were negative in PE and CT, with the largest nodal diameters smaller than 10 millimeters in CT. The different neck dissections were performed on the patients with the cervical lymph nodes negative in PE. To define the range of dissection, the sentinel lymph nodes were detected by injecting dye during operation. According to the histopatholo- gical results and the cervical lymph nodal situation in 3 years and 5 years after operation, the diagnosis significance and effects of the neck dissections were analyzed. Results The metastasis rate in group I was 58.8 %. There were bilateral metastases in 3 cases, mainly located in the level Ⅱ , Ⅲ and Ⅳ regions. There was no positive lymph node in the region V. In group Ⅱ , the metastasis rate was 38.1% （8/21）. There was bilateral metastasis in 1 case, located in regions Ⅱ and Ⅲ. There was no positive lymph node in regions IV and V. In group Ⅲ, the sentinel lymph nodes were successfully detected in 69.6 % patients during operation, but 1 case was found to be positive in the frozen in spection during operation,3 cases （13.0%） were found to be positive by means of the successive histotomy,without bilateral and located in region Ⅱ. The range of dissection was involved with the positive lymph nodes and the next station of the nodes. The 3-year and 5-year recurrent rates were 16.3 % and 26.2 %, respectively. The recurrent rates were significantly different by case-control study. Conclusion Combining PE a