von Buchwald Christian, Bradley Patrick J
Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet and Faculty of Health Sciences, University of Copenhagen, Denmark.
Curr Opin Otolaryngol Head Neck Surg. 2007 Apr;15(2):95-8. doi: 10.1097/MOO.0b013e3280803d9b.
The majority of inverted nasal papilloma are benign and treatment is by complete local surgical removal. There is an associated real, but small risk of malignancy, which may coexist at the time of presentation or develop at a later time. This article reviews some of the recent publications addressing the association of inverted papilloma with malignancy.
Neither the etiology of inverted papilloma nor the factors responsible for malignant transformation are fully elucidated to date. Inverted papilloma is associated with squamous cell carcinoma in approximately 10% of the cases. Malignancy may occur synchronously or metachronously.
Based on the literature, the rates of synchronous and metachronous carcinoma are 7.1 and 3.6%, respectively, although rates may be exaggerated due to a referral bias to tertiary centres. A thorough removal of all diseased mucosa is curative and a meticulous histological examination of the entire specimen is necessary. The working risk is approximately 10%. Recurrent disease and metachronous carcinoma can develop after a prolonged period of time. As most recurrences are due to incomplete resection, it is mandatory to perform a close follow-up, with biopsies performed when indicated. Life-long follow-up is recommended.
大多数内翻性乳头状瘤是良性的，治疗方法是进行局部手术完整切除。其存在一定的恶变风险，虽实际发生率低，但可能在初次就诊时就已存在恶变，也可能在之后发生。本文回顾了一些近期关于内翻性乳头状瘤与恶变相关性的出版物。
迄今为止，内翻性乳头状瘤的病因及恶变相关因素均未完全阐明。约10%的内翻性乳头状瘤病例与鳞状细胞癌相关。恶变可能同时发生或异时发生。
根据文献，同时性和异时性癌的发生率分别为7.1%和3.6%，不过由于向三级中心转诊的偏倚，实际发生率可能被高估。彻底切除所有病变黏膜可治愈疾病，对整个标本进行细致的组织学检查很有必要。实际恶变风险约为10%。疾病复发和异时性癌可能在较长时间后发生。由于大多数复发是由于切除不彻底，因此必须进行密切随访，必要时进行活检。建议进行终身随访。
