声带白斑癌变的影响因素分析  

Risk factors of malignant transformation in vocal cord leukoplakia

作　　者：汪文斌[1] 苏仁杰[1] 彭倩华 张祥文[1] 应正标[1] 

机构地区：[1]温州医科大学附属温岭医院耳鼻咽喉科,温岭317500

出　　处：《中国眼耳鼻喉科杂志》2016年第6期415-418,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：温岭市科技计划资助基金(2015C311036;2012WLCD0088);2016年台州市科技计划项目(1601KY44)

摘　　要：目的探讨声带白斑癌变的相关影响因素。方法回顾分析186例声带白斑患者的临床资料,分析患者性别、年龄、吸烟、酗酒、病变范围、是否累及前连合、组织病理分级与声带白斑癌变的关系,筛选与声带白斑癌变相关的变量,选入Logistic回归分析模型,计算这些因素的相对危险度(OR值)及95%可信区间。结果 186例声带白斑中25例发生了癌变,癌变率为13.4%。其中,白斑范围、是否累及前连合、组织病理分级被选入Logistic回归分析模型。Logistic回归分析结果表明,是否累及前连合、组织病理分级是声带白斑癌变的影响因素,而病变范围不是声带白斑癌变的影响因素。声带白斑累及前连合的癌变风险是不累及前连合的10.16倍;病理为中度异常增生(SIN2)的癌变风险是单纯增生伴或不伴角化(KWD)的11.06倍,而重度异常增生(SIN3)的癌变风险是KWD的140.17倍。结论声带白斑癌变与累及前连合、组织病理分级相关,累及前连合、组织病理分级为SIN2和SIN3的声带白斑为高风险癌变组。Objective To investigate the risk factors of malignant transformation in vocal cord leukoplakia. Methods A total of 186 cases with vocal cord leukoplakia were analyzed retrospectively. Single factor test was performed to examine the associations between malignant transformation in vocal cord leukoplakia and each of the risk factors including sex, age, smoking, alcohol consumption, size, whether involving the anterior commissure and histopathological classification. Then the associations of these selected factors with malignant transformation in vocal cord leukoplakia were evaluated by fusing multiple Logistic regression analysis. Results Twenty-five cases of all 186 patients with vocal cord leukoplakia developed larynx cancer. The ratio of malignant transformation was 13.4%. Size, whether involving the anterior commissure and histopathological classification were chosen as risk factors which were incorporated into the multiple Logistic regression models. The multiple Logistic regression showed that whether involving the anterior commissure and histopathological classification were the risk factors of malignant transformation in vocal cord leukoplakia, but the size was not. The risk of involving the anterior commissure was 10. 16 times as high as that not involving the anterior commissure. The risk of moderate dysplasia was 11.06 times as high as that with hyperplasia, while severe dysplasia was 140.17 times. Conclusions Involving of the anterior commissure and histopathological classification were the risk factors of malignant transformation in vocal cord leukoplakia. （Chin J Ophthalmol and Otorhinolaryngol,2016, 16：415-418）

关 键 词：声带白斑 癌变 影响因素 

分 类 号：R739.65[医药卫生—肿瘤]