Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Chungnam National University, 640 Daesa-Dong, Chung-Gu, Daejeon, 301-721, South Korea.
Eur Arch Otorhinolaryngol. 2012 Nov;269(11):2349-54. doi: 10.1007/s00405-012-1935-5. Epub 2012 Jan 24.
The objectives of the study were to analyze the clinical features of inverted papillomas (IP) associated with malignancy and to evaluate the correlation of tumor stage, survival and histolologic features. We conducted a retrospective review of 18 IP associated with malignancy patients. In addition, we compared histopathologic characteristics (tumor differentiation and malignant cell proportion) with clinical outcomes. Eleven of the tumors were present on the nasal cavity and 7 on the maxillary sinus. The rates of synchronous and metachronous malignancy were 10.1 and 1.1%, respectively. The disease-free survival rate was 83.3%. The tumors were staged as T1 (5/18), T2 (2/18), T3 (8/18), and T4 (3/18). According to the percentage of the malignant cell in the entire tumor tissue, 4 patients (22%) were in grade I, 4 patients (22%) were in grade II, 3 patients (17%) were in grade III, and 7 patients (39%) were in grade IV. There was no relationship between recurrence- and/or disease-free survival and histologic findings including tumor differentiation and malignant proportion. IP-associated malignancy tends to occur synchronously and have more favorable prognosis compared to other sinonasal malignancy. Furthermore, the proportion of malignant cell to IP and tumor stage seems not to affect the clinical outcome of IP-associated malignancy.
本研究的目的是分析与恶性肿瘤相关的内翻性乳头状瘤（IP）的临床特征，并评估肿瘤分期、生存和组织学特征的相关性。我们对 18 例与恶性肿瘤相关的 IP 患者进行了回顾性分析。此外，我们还比较了组织病理学特征（肿瘤分化和恶性细胞比例）与临床结果的相关性。11 例肿瘤位于鼻腔，7 例位于上颌窦。同步和异时恶性肿瘤的发生率分别为 10.1%和 1.1%。无疾病生存率为 83.3%。肿瘤分期为 T1（5/18）、T2（2/18）、T3（8/18）和 T4（3/18）。根据整个肿瘤组织中恶性细胞的百分比，4 例（22%）为 I 级，4 例（22%）为 II 级，3 例（17%）为 III 级，7 例（39%）为 IV 级。复发和/或无病生存率与肿瘤分化和恶性比例等组织学发现之间无相关性。与其他鼻窦恶性肿瘤相比，IP 相关恶性肿瘤更倾向于同步发生，且预后更好。此外，恶性细胞在 IP 中的比例和肿瘤分期似乎并不影响 IP 相关恶性肿瘤的临床结果。
