鼻腔鼻窦肿瘤临床特征和病理组织学特点的分析  

Analysis of the clinical and pathological characteristics of sinonasal neoplasms

作　　者：王小婷[1] 时光刚[1] 刘亦青[1] 纪宏志[1] 何明强[1] 李建峰[1] 王海波[1] 

机构地区：[1]山东大学附属省立医院耳鼻咽喉头颈外科,济南250021

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第23期1071-1075,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:研究鼻腔鼻窦肿瘤的临床特征及病理组织学特点。方法:收集活检或手术切除,经病理证实的333例鼻腔鼻窦肿瘤患者,统计其发病年龄、性别、部位分布及病理构成比,观察其临床特征及病理组织学特点。结果:①所有患者中,男200例,女133例;男女比为1.5∶1;年龄2～84岁,中位年龄54岁;良性肿瘤177例,恶性肿瘤156例,良性恶性比为1.1∶1。原发于鼻腔的肿瘤有142例;原发于鼻窦的肿瘤191例,包括上颌窦肿瘤90例,额窦肿瘤31例,筛窦肿瘤46例,蝶窦肿瘤24例,其中55例累及鼻腔。②本组鼻腔鼻窦肿瘤总的构成比按组织来源排序为上皮组织、软组织、淋巴造血组织、骨及软骨组织、异位颅内组织肿瘤;恶性肿瘤排在前5位的是鳞状细胞癌、淋巴瘤、腺样囊性癌、恶性黑素瘤、嗅神经母细胞瘤;良性肿瘤排在前5位的是乳头状瘤、纤维瘤、骨瘤、血管瘤、异位颅内良性肿瘤。③上皮组织来源者共200例,良性恶性比为1.4∶1(118∶82)。软组织肿瘤共68例,良性恶性比为1.2∶1(37∶31)。骨与软骨组织肿瘤22例,良性恶性比为3.4∶1(17∶5),良性者均为骨瘤。淋巴造血组织来源的肿瘤29例,以恶性为主有28例。异位颅内肿瘤也可见到,共2例。此外,还收集到其他各种类型肿瘤12例。结论:鼻腔鼻窦肿瘤有明确的临床特征,不同部位的肿瘤有不同的临床发生特点;可以发生多种组织类型的肿瘤,其中以内翻性乳头状瘤、鳞状细胞癌、纤维瘤、骨瘤、淋巴瘤、腺样囊性癌最为常见,在临床病理学上具有多样性和复杂性的特点,鼻腔鼻窦肿瘤的诊断及鉴别诊断主要依靠病理检查;治疗采取以手术为主的综合治疗。Objective：To investigate the clinical and pathological characteristics of sinonasal neoplasms.Method：A cohort of 333 patients with sinonasal neoplasm,which were confirmed by surgical pathology,were enrolled in this study.The clinicopathological characteristics,in terms of age,sex,location,and disease constituent ratio were retrospectively reviewed.Result：①In this series of patients,there were 200 males and 133 females,aged from 2 to 84 years,with a median of 54 years.The benign to malignant ratio was 1.1∶1.As for their origination,144 tumors arose from the nasal cavity,while,191 tumors derived from sinus,including 90 from maxillary sinus,31 from frontal sinus,46 from ethmoid sinus,and 24 from sphenoidal sinus.②Disease constituent ratio decreased in order of epithelial tissue,soft tissue,lymphohematopoietic tissue,bone and cartilaginous tissue,ectopic intracranial tumors.The five most frequent malignant tumors were squamous carcinoma,lymphoma,adenoid cystic carcinoma,malignant melanoma and esthesioneuroblastoma,while,benign tumors ranked in the top five were papilloma,fibroma,osteoma,angioma and ectopic intracranial tumors,respectively.③Of 200 cases arising from epithelium,118 were benign,82 were malignant,and the benign to malignant ratio was 1.4∶1.Of 68 cases from soft tissue,37 were benign and 31 were malignant tumors（ratio,1.2∶1）.Among the 22 cases from bone and cartilaginous tissue,17 were benign and 5 were malignant（ratio,3.4∶1）.With respect to the 29 cases from lymphohematopoietic tissue,the majority of tumors were malignant（28 cases）,with only one benign case.In addition,ectopic intracrnial tumors were also observed.Besides the above all,12 cases of other types were found in this work.Conclusion：Neoplasms from different parts of nasal cavity and paranasal sinus have specific clinical characteristics.The pathological types of these tumors may be highly diversed.The diagnosis and differential diagnosis depend mainly on pathological examination.Comprehensive treatment,which e

关 键 词：鼻肿瘤 临床 病理学 治疗 

分 类 号：R739.62[医药卫生—肿瘤]