Zhang Hong Kai, Liu Hong Gang
Department of Pathology, Beijing Tongren Hospital, affiliated to the Capital Medical University, PR China.
Acta Otolaryngol. 2012 Mar;132(3):325-8. doi: 10.3109/00016489.2011.642812. Epub 2012 Jan 9.
Our results showed that the behavior of moderate dysplasia lesions was more like that of severe dysplasia lesions, while severe dysplasia was very different from carcinoma in situ (CIS). CIS should be managed more aggressively than the other lesions. Mild dysplasia could not be viewed as a precancerous lesion of the larynx.
This study aimed to identify the possibilities of the precancerous lesions of larynx (including mild dysplasia, moderate dysplasia, severe dysplasia, and CIS) progressing to invasive carcinomas and to highlight the importance of adequate management and follow-up strategies for these patients.
A retrospective study of patients who had these preinvasive lesions in the larynx over a 10-year period was performed.
These patients were followed for a minimum period of 2 years from the initial diagnosis. In all, 86 patients were identified the cohort. Of these, 17 (19.8%) patients developed carcinoma: 0 of 22 with mild dysplasia, 5 of 25 (20%) with moderate dysplasia, 2 of 14 (15%) with severe dysplasia, and 10 of 25 (40%) patients with CIS progressed to invasive cancers (p = 0.001). Over 50% of cases progressed 3 years after the original biopsy. Only 1 of 86 (1%) died of the disease.
我们的结果显示，中度发育异常病变的行为更类似于重度发育异常病变，而重度发育异常与原位癌（CIS）非常不同。CIS的处理应比其他病变更积极。轻度发育异常不能被视为喉癌前病变。
本研究旨在确定喉癌前病变（包括轻度发育异常、中度发育异常、重度发育异常和CIS）进展为浸润性癌的可能性，并强调对这些患者进行适当管理和随访策略的重要性。
对10年间患有这些喉癌前病变的患者进行回顾性研究。
这些患者从最初诊断起至少随访2年。总共确定了86例患者纳入队列。其中，17例（19.8%）患者发生了癌变：22例轻度发育异常患者中0例，25例中度发育异常患者中5例（20%），14例重度发育异常患者中2例（15%），25例CIS患者中有10例（40%）进展为浸润性癌（p = 0.001）。超过50%的病例在初次活检3年后进展。86例中只有1例（1%）死于该病。
