成人喉乳头状瘤复发的相关因素研究  

Multivariate analysis of the parameters related to recurrence of laryngeal papilloma in adult

作　　者：姚丽青[1] 陈曦[2] 杨劲松[2] 

机构地区：[1]南京军区福州总医院病理科,福州350001 [2]福建医科大学附属第一医院耳鼻咽喉研究所

出　　处：《临床耳鼻咽喉科杂志》2004年第12期743-744,共2页Journal of Clinical Otorhinolaryngology

基　　金：福建省教委科研基金资助项目 (No :0 0A0 5 5 )

摘　　要：目的 :研究成人喉乳头状瘤复发的相关因素。方法 :收集成人喉乳头状瘤复发标本 5 0例 ,另选 10例炎症病变黏膜组织作为对照。应用SP法检测石蜡标本中耐药基因胎盘型谷胱甘肽 S 转移酶 (GST π)、DNA拓朴酶Ⅱ (TopoⅡ )、P 糖蛋白 (Pgp)和Ki 6 7、血管内皮生长因子 (VEGF)的表达 ,并用形态计量方法检测肿瘤内微血管密度 (MVD) ,对所得的各项指标进行统计学分析。结果 :①耐药基因Pgp、GST π和TopoⅡ的表达与年龄、性别、肿瘤大小及肿瘤复发无显著相关 (P >0 .0 5 )。②Ki 6 7在复发肿瘤与非复发肿瘤组织之间差异有统计学意义 (P <0 .0 1)。多元回归分析显示该指标是肿瘤复发的独立危险因素之一 ,以 39%为分界点 ,大于 39%者容易复发。③MVD >19(× 2 0 0 )的成人喉乳头状瘤比 <19的成人喉乳头状瘤容易复发。结论 :用Cox 逐步回归模型进行多因素分析 ,筛选出了与成人喉乳头状瘤复发有密切关系的 5个指标 :Ki 6 7阳性率是最重要的复发因子 ,其次为MVD ,而肿瘤耐药因子Pgp、TopoⅡ、GST π无明显意义。Objective:To investigate the clinical and pathological characteristics of astrocytoma and the factors related to pathological gradings as well as recurrence in laryngeal papilloma in adult.Method:Fifty samples from patients were selected and 10 cases of normal tissue or inflammation tissue were used as control group. The expression of Pgp、GST-π、TopoⅡ and Ki-67 and VEGF by immunohistochemical stain and the microvessel density by morphometry were studied.Result:①The positive rates of Pgp,GST-π and TopoⅡ were not correlated with the age、sex、tumor size and the recurrence(P> 0.05).②Both recurrent tissue and current tissue showed various positivity for Ki-67.The difference were significant(P<0.01).Taking 39% of Ki-67 expression as threshold,there was significant difference between two curves indicating favorable recurrence in the tumor group respectively(P<0.01).③Microvascular changes,such as the density of blood vessels demonstrated significantly difference between the two tumor group (P<0.01).An average vessel count of more than 19(×200)suggested an easier recurrence.Conclusion:Use of the cox-regression model in multivariate analysis shows that there are five parameters closely related to the recurrence of laryngeal papilloma in adult,of which the Ki-67 is the most critical factor,second the microvessel density,while Pgp,TopoⅡ and GST-π in tumor are independent favorable factors for laryngeal papilloma of adult.

关 键 词：喉肿瘤 乳头状瘤 肿瘤复发 

分 类 号：R739.65[医药卫生—肿瘤]