Ung thư biểu mô vảy của đường hô hấp và tiêu hóa trên

HNO - Tập 52 - Trang 783-789 - 2004
S. Wenzel1,2, U. Koch1
1Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde des Universitätsklinikums Hamburg-Eppendorf
2Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Tóm tắt

Sự vỡ bao và sự phát tán ngoài bao tiếp theo của di căn hạch bạch huyết là một yếu tố quyết định cho tiên lượng của bệnh nhân mắc ung thư biểu mô vảy ở đường hô hấp và tiêu hóa trên. Ngoài việc định nghĩa sự vỡ bao là sự tiếp xúc của di căn với mô mỡ quanh hạch, không có một tiêu chuẩn hình thái học rõ ràng nào về mức độ phát triển xuyên qua bao. Do đó, một hệ thống đánh giá mô học bảy cấp đã được phát triển, nhằm ghi nhận mức độ di căn từng phần của hạch bạch huyết dưới dạng tăng trưởng trong hạch, xâm nhập bao, sự desmoplastia, vỡ bao, và sự phát tán khối u ngoài bao tiếp theo. Việc chỉ định sự di căn ngoài bao là một sự bổ sung hợp lý cho hệ thống TNM hiện tại nhờ vào tính tái lập đáng tin cậy và tầm quan trọng trong việc tiên lượng. Cách tốt nhất để áp dụng điều này là bằng cách bổ sung vào danh mục N bằng chỉ số R+ (di căn hạch bạch huyết với vỡ bao) hoặc R− (di căn hạch bạch huyết không có vỡ bao) phía sau N.

Từ khóa

#ung thư biểu mô vảy #di căn hạch bạch huyết #hệ thống TNM #vỡ bao #tiên lượng

Tài liệu tham khảo

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