Szewczyk A J
Oddziału Otolaryngologicznego Szpitala Miejskiego im. Fr. Raszei, Poznaniu.
Otolaryngol Pol. 1992;46(5):448-56.
310 patients were analysed with different pathological changes in the larynx, which are classified as premalignant stages and 114 cases with early cancer of the vocal cords. Out of the 310 cases, 230 cases were with chronic hypertrophic laryngitis, 44 cases with hyperkeratotic papilloma and 36 with juvenile papilloma in adults. Histologic verification of the bioptic and operative material was performed in a series of examinations. This showed that leukoplakia and one-sided pathological changes of the larynx are clinically characteristic for carcinogenesis. In chronic hypertrophy with leukoplakia, cell dysplasia occurred in 12.2% and atypia occurred in 9.8%. Hyperkeratotic papilloma underwent malignant transformation in 70.5% cases. Among the juvenile papilloma in adults with frequent recurrence of the disease, leukoplakia and dysplasia occurred periodically. Idiopathic malignant transformation of juvenile papilloma happened in only one patient. Adequate treatment of the premalignant stages effectively prevents further growth of cancer in 97% of the cases. Surgical treatment of cancer of the glottis in T1N0 and T2N0 gave a 5-year and longer survival period in 82.8%. There results were better than after radiotherapy of about 15%.
对310例喉部有不同病理变化的患者进行了分析,这些变化被归类为癌前阶段,另有114例声带早期癌患者。在这310例病例中,230例为慢性肥厚性喉炎,44例为角化性乳头状瘤,36例为成人青少年乳头状瘤。在一系列检查中对活检和手术材料进行了组织学验证。结果表明,白斑和喉部单侧病理变化在临床上是致癌的特征。在伴有白斑的慢性肥厚中,细胞发育异常发生率为12.2%,异型性发生率为9.8%。角化性乳头状瘤恶变率为70.5%。在疾病频繁复发的成人青少年乳头状瘤中,白斑和发育异常会周期性出现。青少年乳头状瘤的特发性恶变仅发生在1例患者中。对癌前阶段进行充分治疗可在97%的病例中有效防止癌症进一步发展。声门癌T1N0和T2N0期的手术治疗5年及更长生存期的比例为82.8%。这些结果比放疗后的结果约好15%。