二氧化碳激光治疗喉癌前病变及早期声门型喉癌的临床疗效及预后分析  

Clinical Efficacy and Prognosis Analysis of CO_(2) Laser in Laryngeal Precancerous Lesions and Early Glottic Laryngeal Cancer

作　　者：蔡娣 杨巧云 Cai Di;Yang Qiaoyun(Department of Otolaryngology,Suining Central Hospital,Suining 629000,Sichuan,China)

机构地区：[1]遂宁市中心医院耳鼻咽喉科,四川遂宁629000

出　　处：《肿瘤预防与治疗》2024年第12期1044-1049,共6页Journal of Cancer Control And Treatment

摘　　要：目的:探讨二氧化碳(CO_(2))激光治疗喉癌前病变(laryngeal precancerous lesions,LPL)及早期声门型喉癌(early glottic laryngeal cancer,EGLC)的临床疗效及预后。方法:连续纳入2019年1月至2023年12月期间在我院耳鼻咽喉科行支撑喉镜下CO_(2)激光治疗的61例LPL(喉乳头状瘤15例、声带白斑46例)和30例EGLC患者的临床资料并进行术后随访,采用Kaplan-Meier法计算LPL及EGLC患者经CO_(2)激光治疗后的总生存率(overall survival,OS)和无瘤生存率(disease free survival,DFS),采用Cox比例风险回归模型分析LPL及EGLC患者经CO_(2)激光治疗后复发率的相关影响因素。结果:EGLC患者中,共有3例局部复发,局部复发率为10.0%(3/30),T2期患者局部复发率最高50.0%(1/2),但不同临床分期组间比较未显示有统计学意义(χ^(2)=3.059,P=0.217)。喉乳头状瘤患者局部复发率40.0%(6/15),声带白斑患者局部复发率8.7%(4/46),两组局部复发率差异有统计学意义(χ^(2)=8.088,P=0.004)。多因素Cox回归分析显示:不同疾病类型是LPL患者经CO_(2)激光治疗术后复发的独立危险因素,喉乳头状瘤患者相对于声带白斑患者术后的复发风险更高[RR(95%CI):5.198(1.089~33.228),P=0.044];临床分期是EGLC患者CO_(2)激光治疗术后复发的独立危险因素,T2期相对于Tis患者术后复发风险更高[RR(95%CI):1.758(1.020~5.131),P=0.022]。结论:经CO_(2)激光治疗的LPL患者及EGLC患者的预后OS及DFS均较高,临床疗效显著。喉乳头状瘤是LPL患者术后复发的独立危险因素,临床分期为T2期是影响EGLC患者术后复发的独立危险因素。Objective:To explore the efficacy and prognosis analysis of CO_(2) laser in laryngeal precancerous lesions(LPL)and early glottic laryngeal cancer(EGLC).Methods:Clinical data of 61 cases of LPL(15 cases of laryngeal papilloma and 46 cases of vocal cord leukoplakia)and 30 EGLC patients who underwent CO_(2) laser treatment with supporting laryngoscope in our otolaryngology department from January 2019 to December 2023 were continuously included,and postoperative follow-up was conducted.Kaplan-Meier method was used to calculate the overall survival(OS)and disease-free survival(DFS)of LPL and EGLC patients treated by CO_(2) laser.Cox proportional hazards model was used to analyze the factors influencing the recurrence rate of LPL and EGLC patients after CO_(2) laser treatment.Results:Among EGLC patients,there were 3 cases of local recurrence,with a local recurrence rate of 10.0%(3/30).The highest local recurrence rate occurred in T2 patients[50.0%(1/2)],but there was no statistically significant difference between different clinical stage groups(χ^(2)=3.059),P=0.217).The local recurrence rate of patients with laryngeal papilloma was 40.0%(6/15),and that of patients with vocal cord leukoplakia was 8.7%(4/46).There was a statistically significant difference in local recurrence rate between the two groups(χ^(2)=8.088,P=0.004).Multivariate Cox regression analysis showed that disease type was an independent risk factor for recurrence in LPL patients after CO_(2) laser treatment.Patients with laryngeal papilloma had a higher risk of recurrence after surgery compared to those with vocal cord leukoplakia(RR=5.198,95%CI:1.089~33.228,P=0.044).Clinical stage is an independent risk factor for recurrence after CO_(2) laser treatment in EGLC patients.T2 patients have a higher risk of postoperative recurrence compared to patients with cancer in situ(RR=1.758,95%CI:1.020~5.131,P=0.022).Conclusion:The OS and DFS of LPL or EGLC patients treated with CO_(2) laser are relatively high,and the clinical efficacy is significant.Laryngeal p

关 键 词：喉癌前病变 早期声门型喉癌 二氧化碳激光 临床疗效 预后分析 

分 类 号：R739.65[医药卫生—肿瘤]