Zhang X X, Wang J, Xiao Y, Ma L J
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Nov 7;53(11):825-829. doi: 10.3760/cma.j.issn.1673-0860.2018.11.006.
To observe the clinical course of children with juvenile-onset recurrent respiratory papillomatosis (JORRP) until 14 years old. The clinical data of one hundred and twenty cases treated between Januray 1, 2002 and September 30, 2017 in Beijing Tongren Hospital were analyzed retrospectively. Excluding the deaths and the lost, patients who could be ≥ 5 years without recurrence, were defined as the cured group, and < 5 years with recurrence defined as the recurrent group. Furthermore, using statistical methods to analyze the differences of the age of initial operation, total number of operations, invasive lesion, HPV infection, tracheotomy, airway dissemination after tracheotomy and time of tube wear between the two groups. One hundred and three cases were followed up, except for the six deaths.Numbers of operations in eight cases were ≤2, and ≥3 in eighty nine cases.Peak of the primary surgical age were about 4.5 years old, while the self-healing trend occurred at nine years old. In the cured group, forty three cases were cured, with a curative rate of 41.7% (43/103), and there were all fifty four survivors in the recurrent group.The total number of operations, invasive cases, HPV positive cases and the G score of hoarseness in the recurrent group were higher than those in the cured group (=13.02, χ(2)=13.04, χ(2)=17.37, =-4.59, <0.05). The number of tracheal dissemination caused by tracheotomy in the recurrent group (66.7%, 27.8%)was more than that in the cured group (χ(2)=16.01, <0.05). Compared with the time of wearing a tracheostomy tube in cured group, the recurrent group was longer ((3.4±3.1) years vs (8.3±6.7) years, χ(2)=7.19, <0.05). 41.7% of the patients had no relapse for at least five years.There exsisted differences between the cured and recurrent group in the following aspects: the total numbers of surgery, the agression of the lesions, tracheal intratracheal dissemination after tracheotomy, the time of tracheotomy, the HPV typing and the G grading of hoarseness.
观察青少年复发性呼吸道乳头状瘤病（JORRP）患儿至14岁的临床病程。回顾性分析2002年1月1日至2017年9月30日在北京同仁医院接受治疗的120例患儿的临床资料。排除死亡和失访病例，将无复发≥5年的患者定义为治愈组，复发<5年的患者定义为复发组。此外，采用统计学方法分析两组患儿初次手术年龄、手术总次数、侵袭性病变、HPV感染、气管切开、气管切开后气道播散及置管时间的差异。除6例死亡病例外，对103例患儿进行了随访。8例患儿手术次数≤2次，89例患儿手术次数≥3次。初次手术年龄高峰约为4.5岁，9岁时出现自愈趋势。治愈组43例治愈，治愈率为41.7%（43/103），复发组54例均存活。复发组手术总次数、侵袭性病例数、HPV阳性病例数及声音嘶哑G分级均高于治愈组（=13.02，χ(2)=13.04，χ(2)=17.37，=-4.59，<0.05）。复发组气管切开导致气管播散的比例（66.7%，27.8%）高于治愈组（χ(2)=16.01，<0.05）。与治愈组相比，复发组气管切开置管时间更长（(3.4±3.1)年 vs (8.3±6.7)年，χ(2)=7.19，<0.05）。41.7%的患者至少5年无复发。治愈组和复发组在以下方面存在差异：手术总次数、病变侵袭性、气管切开后气管内播散、气管切开时间、HPV分型及声音嘶哑G分级。
