Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, Korea.
Laryngoscope. 2013 May;123(5):1087-91. doi: 10.1002/lary.23876. Epub 2013 Mar 11.
OBJECTIVES/HYPOTHESIS: The authors investigated clinical features of squamous cell carcinomas (SCC) arising in sinonasal inverted papillomas (IP) and risk factors responsible for their malignant transformation.
Retrospective analysis.
In total, 162 patients diagnosed with sinonasal IP and treated between 1998 and 2009 at Pusan National University Hospital were enrolled. Their demographic data, information about previous surgery, smoking history, treatment modalities, follow-up duration, recurrence, and presence of malignancy were reviewed retrospectively.
Seventeen patients (10.5%) were diagnosed with SCC arising in sinonasal IPs. Among them, nine (9/162, 5.6%; 9/17, 52.9%) were diagnosed with synchronous malignancies and three (3/162, 1.8%; 3/17, 17.6%) were diagnosed with metachronous malignancies. In five cases (5/162, 3.1%; 5/17, 29.4%), we could not determine whether their malignancies were synchronous or metachronous. Among 53 smokers, 14 (26.4%) had malignant transformation, while only three (2.8%) in 109 nonsmokers had malignant transformation (Odds ratio = 12.7; P < .001). The mean follow-up in the 17 patients with malignancy was 47.0 months. Three patients did not receive surgical treatment and died of progression of SCC. Among the other 14 patients who underwent curative surgeries, four (28.6%) had recurrences, and their mean period to cancer recurrence was 6.3 months. Two of them died of progression of the cancer. Mean survival of the five patients who died was 14.0 months. They all belonged to T4 stage.
Smoking history is associated with malignant transformation of sinonasal IP. It suggests that close follow-up be required in smokers with sinonasal IP in order not to overlook the malignant transformation.
2b.
目的/假设：作者研究了发生于鼻窦内翻性乳头状瘤（IP）的鳞状细胞癌（SCC）的临床特征以及导致其恶性转化的危险因素。
回顾性分析。
共纳入 1998 年至 2009 年期间在釜山国立大学医院诊断为鼻窦 IP 并接受治疗的 162 例患者。回顾性分析了他们的人口统计学数据、既往手术信息、吸烟史、治疗方式、随访时间、复发情况以及恶性肿瘤存在情况。
17 例（10.5%）患者被诊断为鼻窦 IP 内发生的 SCC。其中，9 例（9/162，5.6%；9/17，52.9%）为同期恶性肿瘤，3 例（3/162，1.8%；3/17，17.6%）为异时性恶性肿瘤。在 5 例患者（5/162，3.1%；5/17，29.4%）中，我们无法确定其恶性肿瘤是同期还是异时性。在 53 名吸烟者中，有 14 例（26.4%）发生恶性转化，而在 109 名非吸烟者中只有 3 例（3/109，2.8%）发生恶性转化（比值比=12.7；P<0.001）。17 例恶性肿瘤患者的平均随访时间为 47.0 个月。3 例患者未接受手术治疗，死于 SCC 进展。在其他 14 例接受根治性手术的患者中，4 例（28.6%）复发，癌症复发的平均时间为 6.3 个月。其中 2 例死于癌症进展。5 例死亡患者的平均生存时间为 14.0 个月。他们均属于 T4 期。
吸烟史与鼻窦内翻性乳头状瘤的恶性转化有关。这表明，对于患有鼻窦内翻性乳头状瘤的吸烟者，需要密切随访，以免漏诊恶性转化。
2b。
