Dictor M, Johnson A
Department of Pathology, Lund University Hospital, Lund, Sweden.
Int J Cancer. 2000 Mar 15;85(6):811-4. doi: 10.1002/(sici)1097-0215(20000315)85:6<811::aid-ijc13>3.0.co;2-3.
The nature and pathogenesis of inverted papilloma of the nose and paranasal sinuses are debated. Evidence suggesting a viral association is controversial, and epidemiological evidence has pointed to tobacco smoking as a potential etiologic factor. A retrospective regional cohort of 197 patients with sinonasal papilloma was compared with a cohort of 1583 patients with nasal polyps showing a similar distribution by age and sex. All instances of head-and-neck carcinoma diagnosed in both cohorts during a 38-year calendar period were culled from the regional cancer registry, the incidence rate ratio was computed (papilloma:polyp, on tumors detected at the time of or prior to the index diagnosis), and the clinical details were obtained. Nine instances of oral or laryngeal squamous-cell carcinoma, all in men, were identified in the papilloma cohort, and 7 labial, oral or laryngeal carcinomas (2 in women) in patients with polyps. In addition, 5% of the papillomas progressed to sinonasal carcinoma, including 2 cases among those with other primary head-and-neck carcinomas. The incidence-rate ratio for non-sinonasal head-and-neck carcinoma was 12.8 (95% CI, 3. 7 to 50; p < 0.0001). Among the papilloma patients with oral/laryngeal carcinoma, 8 smoked tobacco. Inverted sinonasal papilloma is associated with an increase in non-sinonasal head-and-neck carcinoma, and tobacco may be a causative link.
鼻腔及鼻窦内翻性乳头状瘤的性质和发病机制存在争议。提示病毒关联的证据颇具争议，而流行病学证据指出吸烟是一个潜在病因。一项针对197例鼻窦乳头状瘤患者的回顾性区域队列研究与一个1583例鼻息肉患者队列进行了比较，后者在年龄和性别分布上与之相似。在38年的时间里，从区域癌症登记处筛选出两个队列中所有诊断出的头颈癌病例，计算发病率比（乳头状瘤：息肉，基于索引诊断时或之前检测到的肿瘤），并获取临床细节。在乳头状瘤队列中，共识别出9例口腔或喉鳞状细胞癌，均为男性；息肉患者中有7例唇、口腔或喉癌（2例为女性）。此外，5%的乳头状瘤进展为鼻窦癌，其中包括2例合并其他原发性头颈癌的患者。非鼻窦头颈癌的发病率比为12.8（95%可信区间，3.7至50；p<0.0001）。在患有口腔/喉癌的乳头状瘤患者中，8人吸烟。鼻窦内翻性乳头状瘤与非鼻窦头颈癌的增加有关，吸烟可能是一个因果联系。
