Niu Y Y, Wang J, Huo H, Jin X F, Li W Y, Gao Z Q
Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Aug 7;53(8):575-580. doi: 10.3760/cma.j.issn.1673-0860.2018.08.004.
To investigate the etiology, clinical and pathological characteristics of laryngeal leukoplakia and the predictive risk factors of recurrence and malignant transformation. Clinical data of 263 patients with laryngeal leukoplakia between January 2000 and December 2015 were analyzed retrospectively. The pathological diagnoses included squamous epithelial hyperplasia (54.4%), mild dysplasia (17.9%), moderate dysplasia (12.2%), severe dysplasia and carcinoma in situ (12.5%), and invasive carcinoma (3.0%). Age and the extent of lesion were statistically different among different pathological groups (<0.05). Gender, smoking and alcohol consumption did not show statistical differences among different pathological groups (>0.05). Follow-up of 215 patients, excluding 6 cases of invasive carcinoma. The recurrence rate was 20.6%(43/209), and the malignant transformation rate was 5.3%(11/209). Multivariate analysis showed that pathological classification of moderate to severe dysplasia was the independent risk factor for recurrence and malignant transformation of laryngeal leukoplakia (<0.05). In patients with severe dysplasia and carcinoma the recurrence proportion of conservative treatment, vocal cords (partial) resection and radiotherapy were 8/10, 0/10 and 2/11 respectively. Laryngeal leukoplakia occurs frequently in elderly men with long-term smoking history. Pathological diagnoses are different. The grade of dysplasia is the predictive risk factor for the recurrence and malignant transformation of laryngeal leukoplakia. More aggressive treatment and closer follow-up should be warranted for patients with moderate dysplasia, severe dysplasia and carcinoma in situ.
探讨喉白斑病的病因、临床及病理特征以及复发和恶变的预测危险因素。回顾性分析2000年1月至2015年12月期间263例喉白斑病患者的临床资料。病理诊断包括鳞状上皮增生（54.4%）、轻度异型增生（17.9%）、中度异型增生（12.2%）、重度异型增生和原位癌（12.5%）以及浸润癌（3.0%）。不同病理组之间年龄和病变范围有统计学差异（<0.05）。性别、吸烟和饮酒在不同病理组之间无统计学差异（>0.05）。对215例患者进行随访，排除6例浸润癌患者。复发率为20.6%（43/209），恶变率为5.3%（11/209）。多因素分析显示，中度至重度异型增生的病理分类是喉白斑病复发和恶变的独立危险因素（<0.05）。在重度异型增生和原位癌患者中，保守治疗、声带（部分）切除术和放疗的复发比例分别为8/10、0/10和2/11。喉白斑病常见于有长期吸烟史的老年男性。病理诊断各异。异型增生程度是喉白斑病复发和恶变的预测危险因素。对于中度异型增生、重度异型增生和原位癌患者，应采取更积极的治疗并进行更密切的随访。
