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二氧化碳激光治疗后声带白斑的复发

Recurrence of vocal fold leukoplakia after carbon dioxide laser therapy.

作者信息

Chen Min, Chen Jian, Cheng Lei, Wu Haitao

机构信息

Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Key Clinical Disciplines of Otorhinolaryngology, 83 Fenyang Road, Shanghai, 200031, China.

出版信息

Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3429-3435. doi: 10.1007/s00405-017-4632-6. Epub 2017 Jun 9.

Abstract

This work aims to analyze the recurrence of vocal fold leukoplakia after carbon dioxide (CO) laser resection. In this retrospective study, all patients undergoing CO laser resection of vocal fold leukoplakia were followed up for at least 2 years. Recurrence was diagnosed as any presence of leukoplakia in the vocal cord subsequent to previous successful complete resection. A total of 326 patients with complete resection of vocal fold leukoplakia and follow-up subsequent surveillance laryngoscopy were studied. The recurrence rate, the recurrence time, and risk factors were evaluated. Of these, 52 (16.0%) patients experienced recurrence with a mean follow-up time of 50.5 ± 15.4 months. The mean time to recurrence was 16.2 ± 14.1 months. Univariate analysis showed that the size of lesion (P < 0.001, Pearson χ test; P < 0.001, log-rank test) and the pathological grade (P = 0.025, Pearson χ test; P = 0.028, log-rank test) were significantly related to recurrence. The size of lesion was an independent prognostic factor for recurrence using multivariate analysis (P = 0.001, logistic regression; P = 0.001, Cox proportional hazards model). Considering the possible recurrence of vocal fold leukoplakia, long-term follow-up is required after CO laser resection. In conclusion, the size of lesion combined with the pathological grade are important risk factors that predict vocal fold leukoplakia recurrence.

摘要

这项研究旨在分析二氧化碳(CO)激光切除术后声带白斑的复发情况。在这项回顾性研究中,所有接受CO激光切除声带白斑的患者均接受了至少2年的随访。复发被定义为在先前成功完全切除后声带中出现任何白斑。共研究了326例声带白斑完全切除并随后接受随访喉镜检查的患者。评估了复发率、复发时间和危险因素。其中,52例(16.0%)患者出现复发,平均随访时间为50.5±15.4个月。复发的平均时间为16.2±14.1个月。单因素分析显示,病变大小(P<0.001,Pearsonχ检验;P<0.001,对数秩检验)和病理分级(P=0.025,Pearsonχ检验;P=0.028,对数秩检验)与复发显著相关。使用多因素分析时,病变大小是复发的独立预后因素(P=0.001,逻辑回归;P=0.001,Cox比例风险模型)。考虑到声带白斑可能复发,CO激光切除术后需要长期随访。总之,病变大小与病理分级是预测声带白斑复发的重要危险因素。

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