声带白斑黏膜剥脱术复发及癌变的预后研究

发布时间：2018-01-22 08:14

本文关键词： 声带白斑复发癌变预后因素　出处：《中国微创外科杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨影响声带白斑黏膜剥脱术的临床预后相关因素。方法回顾性分析1998年1月~2013年12月416例因声带白斑行黏膜剥脱术的临床资料,计算术后1、3、5年复发率和癌变率,并用COX单因素分析性别、年龄、吸烟、酗酒、白斑范围、组织病理与声带白斑术后复发、癌变的关系,筛选与复发、癌变相关的变量,进入多元COX回归分析模型。结果 416例黏膜剥脱术后声带白斑复发107例,癌变43例,其中1、3、5年复发率分别为9.4%、20.8%、26.0%,癌变率分别为1.9%、6.7%、10.2%。年龄、白斑范围、组织病理均被选入复发及癌变多元COX回归分析模型。多元COX回归分析结果表明:白斑范围、组织病理是影响声带白斑术后复发的预后因素;组织病理是影响声带白斑术后癌变的预后因素。结论声带白斑黏膜剥脱术后复发与白斑范围、组织病理相关,癌变与组织病理相关;组织病理为中度异型增生和重度异型增生的声带白斑为术后高风险复发、癌变组。
[Abstract]:Objective to investigate the clinical prognostic factors of vocal cord leukoplakia exfoliation. Methods the clinical data of 416 patients with vocal cord leukoplakia from January 1998 to December 2013 were analyzed retrospectively. The recurrence rate and canceration rate were calculated at 1, 5 years postoperatively. The relationship between sex, age, smoking, alcoholism, leukoplakia, histopathology and recurrence and canceration of vocal cord leukoplakia was analyzed by COX. Results 107 cases of vocal cord leukoplakia recurred and 43 cases of carcinogenesis were diagnosed by multivariate COX regression analysis after mucosal exfoliation. The recurrence rate for 5 years was 9.4and 20.80.The canceration rate was 1.96.7and 10.2. age and range of leukoplakia respectively. Multivariate COX regression analysis showed that the range of leukoplakia and histopathology were the prognostic factors of postoperative recurrence of vocal cord leukoplakia. Conclusion recurrence of vocal cord leukoplakia is related to the extent of leukoplakia, histopathology, carcinogenesis and histopathology. Histopathology of vocal cord leukoplakia with moderate dysplasia and severe dysplasia was high risk of recurrence and carcinogenesis.
【作者单位】：浙江大学医学院附属第二医院耳鼻咽喉科;温州医科大学附属温岭医院耳鼻咽喉科;
【基金】：浙江省公益技术研究社会发展项目(2013c33132) 台州市科技计划项目(1601KY44)
【分类号】：R767.91
【正文快照】： 声带白斑(leukoplakia of the vocal cord)表现为声带表面或边缘附着的白色斑块状或疣状隆起病变,病变范围或局限或遍布声带全长,病变深度位于黏膜层或侵及黏膜下层[1]。其病理呈多样性,涵盖**通讯作者,E-mail:fanguokang@163.com1现工作单位:温州医科大学附属温岭医院耳鼻咽

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