Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
Eur Arch Otorhinolaryngol. 2013 Mar;270(4):1349-53. doi: 10.1007/s00405-012-2216-z. Epub 2012 Oct 12.
The aim is to study clinical characteristics and recurrence rates for sinonasal inverted papilloma (NIP), to evaluate relevant factors for its recurrence, and to compare the curative rates of different surgical approaches. The Krouse classification for the 156 follow-up cases of the patients with NIP was as following: 26 cases in T1, 33 cases in T2, 94 cases in T3, and 3 cases in T4. A total number of 99 cases of endoscopic sinus surgery were included, of which 26 cases of lateral rhinotomy approach were combined with Caldwell Luc approach, and 31 cases of nasal endoscopy combined with traditional surgery, with average postoperative follow-up of 3-11 years. Of the 156 studied patients with NIP, male:female = 1.69:1, age varied from 18 to 77 years, with average of 56 years, 19 cases showed postoperative recurrence, of which 8 cases developed to be squamous cell carcinoma. Among these 8 cases, 3 patients showed no recurrence after treatment in 5 years, and the other 5 patients died in 3-2 years period. Tumor recurrence rates for different surgical approach are: 9.09 % for endoscopic surgical group, 23.08 % for traditional surgical group, and 12.12 % for combined surgical group; tumor malignancy rates for different surgical approach are: 2.02 % for endoscopic surgical group, 11.54 % traditional surgical group, and 9.09 % for combined group, and Chi-square test showed that the differences in recurrence and malignancy rates for NIP patients with different surgical treatments were not statistically significant (P > 0.05). Recurrence rates for different stages are: T1 at 3.85 %, T2 at 12.12 %, T3 at 14.89 %, and T4 at 0.00 %, and the differences in the recurrence rates for different stages were not statistically significant (P > 0.05) by Chi-square test. There are clear clinical features for NIP, and the recurrence is related to the thoroughness of the first time surgical removal of lesions and is less relevant with Krouse classification stage and surgical approaches.
研究鼻腔鼻窦内翻性乳头状瘤（NIP）的临床特征和复发率，评估其复发的相关因素，并比较不同手术方法的治愈率。对 156 例 NIP 患者的随访病例进行 Krouse 分类：T1 期 26 例，T2 期 33 例，T3 期 94 例，T4 期 3 例。共 99 例患者行内镜鼻窦手术，其中 26 例行外侧径路鼻侧切开术联合 Caldwell-Luc 入路，31 例行鼻内镜联合传统手术，平均术后随访 3-11 年。156 例 NIP 患者中，男：女=1.69：1，年龄 18-77 岁，平均 56 岁，术后复发 19 例，其中 8 例发展为鳞状细胞癌。8 例复发患者中，5 例经治疗后 5 年内无复发，另 3 例复发后 3-2 年内死亡。不同手术方法的肿瘤复发率为：内镜手术组 9.09%，传统手术组 23.08%，联合手术组 12.12%；不同手术方法的肿瘤恶性率为：内镜手术组 2.02%，传统手术组 11.54%，联合手术组 9.09%；卡方检验显示，不同手术方法治疗的 NIP 患者的复发率和恶性率差异无统计学意义（P>0.05）。不同分期的复发率为：T1 期为 3.85%，T2 期为 12.12%，T3 期为 14.89%，T4 期为 0.00%，不同分期的复发率差异无统计学意义（P>0.05）。NIP 具有明显的临床特征，复发与首次手术切除病变的彻底性有关，与 Krouse 分期和手术方式关系不大。
