Cui W X, Xu W, Yang Q W, Cheng L Y
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Dec;30(24):1926-1931. doi: 10.13201/j.issn.1001-1781.2016.24.005.
To investigate the clinical and pathological characteristics of vocal fold leukoplakia and influential factors of recurrence and malignancy. The study included 555 cases of vocal fold leukoplakia. All patients received surgical treatment. The relationship between the clinical and pathological features, and influential factors of recurrence and malignancy were analyzed. The pathological types included squamous epithelial simple hyperplasia in 58.0%, mild hyperplasia in 15.5%, moderate hyperplasia in 10.1%, severe hyperplasia and carcinoma in situ in 8.1%, infiltrative carcinoma in 8.3%. The different pathological types varied among different ages significantly(<0.01). The tobacco and alcohol abuse had no relationship with pathological types(>0.05). The more severe the pathology were, the more decreasing of the mucosal waves would be(<0.01). The pathologic severity had an apparent correlation with p53 positivity and the level of p53 and Ki67 positivity. The p53 positive proportion may increase with the increasing pathological severity(<0.01), so were the p53 and Ki67 positive levels(<0.01).Among 232 cases of postoperation follow-ups, 83 cases(35.8%) relapsed while 8 cases(3.4%) malignancy. Bilateral lesions had a higher rate of relapse and malignancy than unilateral lesions(95% 0.378 ［0.197-0.723］，<0.01). The relapse and malignancy had a relationship with the pathologic severity. The incidence of disease recurrence and malignancy were positively correlated with pathological severity(<0.05). p16 positive patients relapsed for more times(<0.01) and with an uprising tendency of relapse and malignancy（>0.05）. Pathological types of vocal fold leukoplakia are different. The older men, decreasing of mucosal wave of vocal folds and bilateral lesions were very important factors to predict disease severity. p53 and Ki67 positive rating and pathological severity were positively correlated. The bilateral lesions, pathological severity and p16 positivity had a tendency to increasing relapse and malignancy.
探讨声带白斑的临床及病理特征以及复发和恶变的影响因素。该研究纳入了555例声带白斑患者。所有患者均接受了手术治疗。分析了临床及病理特征之间的关系以及复发和恶变的影响因素。病理类型包括鳞状上皮单纯增生占58.0%、轻度增生占15.5%、中度增生占10.1%、重度增生及原位癌占8.1%、浸润癌占8.3%。不同病理类型在不同年龄组中差异有统计学意义（<0.01）。烟酒嗜好与病理类型无关（>0.05）。病理程度越重，黏膜波减弱越明显（<0.01）。病理严重程度与p53阳性及p53和Ki67阳性水平明显相关。p53阳性比例可能随病理严重程度增加而升高（<0.01），p53和Ki67阳性水平也是如此（<0.01）。在232例术后随访病例中，83例（35.
