Glanz H, Kleinsasser O
Arch Otorhinolaryngol. 1976 Feb 8;212(1):57-75. doi: 10.1007/BF00456363.
35 cases of continuous series of 841 laryngeal cancers were studied separately. Those patients had already been suffering from hoarseness for more than 2 years, in the average for 9 years. Many of these patients had been examined and treated by inhalations, and biopsies were taken because of a chronic laryngitis. Clinically in half of the cases a big carcinoma could be found. In 10 cases a chronic laryngitis had been diagnosed; in spite of the preceeding examination by microlaryngoscopy in 4 cases, however, the carcinoma could only be proved by histologic examination. The histologic examinations of the specimens regularly displayed an extended field of epidermisation of the laryngeal mucosa following chronic laryngitis, In these fields of epidermisation the carcinoma developed multicentrically and--in the early stages--mostly showed a covering-like, minutely infiltrating growth. Disseminated dot-like cancer-focuses in the epidermisation field and cancer buds arising from the basal layers of an intact covering of the hypertrophic epithelium could be observed several times. Chronic-hypertrophic laryngitis seems to favour the development of cancer within some patients (promoting factor), it even might accelerate it. As in about 6% of all the vocal cord cancers a preexistent chronic laryngitis is proved by history and clinical findings each patient with a chronic hypertrophic laryngitis must be examined by microlaryngoscopy as well as histological examinations and must be constantly observed.
对连续841例喉癌中的35例进行了单独研究。这些患者已经声音嘶哑超过2年,平均为9年。其中许多患者曾接受过雾化检查和治疗,因慢性喉炎而进行了活检。临床上,半数病例可发现大的癌肿。10例被诊断为慢性喉炎;尽管4例此前曾接受过显微喉镜检查,但癌肿仅通过组织学检查得以证实。标本的组织学检查经常显示慢性喉炎后喉黏膜有广泛的表皮化区域,在这些表皮化区域癌肿多中心发生,且在早期大多呈覆盖样、微小浸润性生长。在表皮化区域可见散在的点状癌灶,以及从肥厚上皮完整覆盖层的基底层长出的癌芽。慢性肥厚性喉炎似乎在一些患者中有利于癌的发生(促发因素),甚至可能加速其发展。由于在所有声带癌中约6%经病史和临床检查证实有既往慢性喉炎,因此每位慢性肥厚性喉炎患者都必须接受显微喉镜检查和组织学检查,并必须持续观察。