64例鼻腔及副鼻窦内翻性乳头状瘤及癌变的临床病理分析  

Clinico pathologic analysis of 64 cases of the inverted papilloma and malignant changes in nose and paranasal sinus

作　　者：陈寿松[1] 柳风轩[2] 杨景[2] 彭正银[1] 

机构地区：[1]广州军区武汉总医院病理科,武汉430070 [2]第三军医大学西南医院病理研究所

出　　处：《肿瘤防治研究》2003年第2期135-137,共3页Cancer Research on Prevention and Treatment

摘　　要：目的　探讨 6 4例鼻腔和副鼻窦内翻性乳头状瘤的临床、病理诊断的特点以及与预后的关系。方法　采用AB及网状纤维染色法观察该瘤粘液细胞和基底膜 ,计算瘤细胞核分裂相数 ,收集有关临床病理资料 ,并随访。结果　 (1)此瘤好发于成年男性 ,病程较长 ;临床常以鼻塞流脓涕及鼻衄为主要症状。 (2 )瘤组织呈乳头状或实巢状向粘膜间质内生长为其组织学特征。 (3)瘤细胞不典型增生Ⅱ级、Ⅲ级及核分裂相 >5个 10HF患者易复发。 (4)瘤细胞不典型增生Ⅲ级核分裂 10～ 2 5 10HF患者易癌变。结论　根据临床和组织学特征提出瘤细胞不典型增生 ,核分裂相数目多少是预测肿瘤复发和恶变的重要指标 ,复发是导致恶变的重要指标之一。Objective To study the features of the inverted papilloma of nose and paranasal sinus in clinic and pathological diagnosis, and relationship in prognosis. Methods 64 cases of this tumor were analyzed. Data in clinicopathologic were collected. Myxocyte and basal membrane were observed with AB(Alcian blue) staining,reticullar fiberstaining and mitotic index were counted by light.All patients were followed up. Results The tumor occurred in male, has a long course of disease. The main symptom was prsented as nasal obstruction pus snot and nosebleed. In the histology the tumor grows in stroma under the bunica mucosa, and in papillform or in groups. When the tumor cellular atypical is 2 and 3 grade and mitotic figures>5/10Hp, the lesion is easy to recurrent. Whereas the cellular atypical is 3 grade and mitotic figures>10～25/10Hp,the lesion is easy to degenerate malignant.Conclusion Basing on the characters of the inverted papilloma of nose and paranasal sinus in clinic and histopathology, we consider that the tumor cellular atypical and mitotic figures might be served as indices for the malignant degeneration and reoccurrence. The reoccurrence is one of the important facts in leading to maligant changes.

关 键 词：副鼻窦内翻性乳头状瘤 癌变 临床 病理 鼻肿瘤 鼻腔肿瘤 诊断 预后 

分 类 号：R739.62[医药卫生—肿瘤]