成人喉乳头状瘤不良进展的特点及相关因素分析  

Analysis of the characteristics and factors associated with the adverse progression of adult laryngeal papilloma

作　　者：丁栋 尹高菲 郭伟[1] 黄志刚[1] DING Dong;YIN Gaofei;GUO Wei;HUANG Zhigang(Department of Otolaryngology Head and Neck Surgery,Bejing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Bejing,100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730

出　　处：《中国耳鼻咽喉头颈外科》2022年第7期442-445,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学基金(82071032)。

摘　　要：目的探究成人喉乳头状瘤患者发生异型增生、癌变的特点,并分析发生不良进展的相关因素。方法收集首都医科大学附属北京同仁医院耳鼻咽喉头颈外科2010年1月~2020年12月手术治疗的成人喉乳头状瘤患者396例,根据术后病理分为病例组137例,对照组259例,分析多种因素与不良进展间关系。结果成人喉乳头状瘤患者异型增生率为31.3%,恶变率为3.3%,总体不良进展率为34.6%。单因素分析结果表明性别、饮酒、病灶多发和手术方式是发生不良进展的相关因素,多因素分析结果表明饮酒和病灶多发是发生不良进展的独立因素。中-重度异型增生进展为喉鳞状细胞癌的时间(6.3个月)短于乳头状瘤进展为轻-中度异型增生的时间(23.2个月)。结论患者饮酒、病灶多发,发生不良进展的风险升高;随着乳头状瘤伴中重度异型增生出现,疾病的进展逐渐加快。OBJECTIVE To investigate the characteristics of dysplasia and canceration in adult patients with laryngeal papilloma,and to analyze the relate factors of adverse progression.METHODS The clinical data of the adult patients with laryngeal papilloma treated surgically between January 2010 and December 2020 at the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University were recorded,and the factors related to the adverse progression were analyzed.RESULTS There were 137 patients in case group and 259 patients in control group.The overall adverse progression was 34.6%,the rate of dysplasia was31.3%,and the rate of canceration was 3.3%.Univariate analysis showed that gender,alcohol consumption,multiple lesions and surgical method were risk factors for adverse progression.Multivariate analysis showed that alcohol consumption and multiple lesion were independent factors of adverse progression;The time of progression of mo derateto-severe dysplasia to cancer(6.3 months)was shorter than the time to progression of papilloma to mild-to-moderate dysplasia(23.2 months).CONCLUSION Adult laryngeal papilloma patients are at elevated risk of adverse progression due to alcohol consumption and multiple lesions.With the appearance of moderate to severe dysplasia of the papilloma,the disease progression is gradually accelerated.

关 键 词：成人 因素分析 乳头状瘤 喉 复发性呼吸道乳头状瘤 

分 类 号：R739.65[医药卫生—肿瘤]