喉頭癌に於ける喉頭全摘後の再發と癌組織像との關係

　我々の教室で最近15年間に喉頭癌の診斷の下に喉頭全摘を行つた患者は約100例に達している．このうち41例が術後再發を來した．術後の再發には色々のFactorが關係するが，臨床的には患者の年齢，癌型，術前リンパ節轉移の有無，手術々式等が再發と最も密接な關係を持つものである．例えば年齢が若い者ほど一般に再發率は高い．喉頭外癌は内癌よりも再發が多い．又術前既に頸リンパ節轉移のある場合はリンパ節摘出を行つても再發が多いのである．此の事に就ては第50回總會席上でも述べた．

　然し喉頭癌組織像と再發との間にどういう關係があるかを詳細に研究した文献は我が國には殆んど無く僅かに米國のGordon New and EleanorFletcherの1篇があるのみである．

IWAMOTO analyzes 97 specimens of larynjeal carcinoma which had been removed by operations and classifies them in accordance to Broder's Histological Grading of Malignancy. He further examines them in terms of the degree of submucous extention of the carcinomatous cells and the relation of this extent to postoperative recurrences.

The results are as follows: (1) No relation is found to be existing between the grade of malignancy and the age of the patient.

(2) The grade of malignancy in intrinsic cancers is found to be low, as well as their relative rate of recurrences postoperatively.

(3) Higher the grade of malignancy the greater it is found the rate at which the cervical lymph glands were to be displaced and the cancers in these stages are inclined to be more disposed to recurrences after the opera-tion.

(4) In general, it is found that the degree of submucous extention of the growths to be corresponding directly proportional to that of the grad of malignancy: and, the larger the extention the more disposed they be towards recurrence after the operation.