- 期刊
Precancerous Lesion of the Larynx: The Correlation of Clinicopathological Finding, Management and Prognostic Result
喉部癌前期病變：臨床及病理所見，處置與預後的關聯性
摘要
喉部白斑症，除了表示喉部黏膜上皮有許多不同的組織學變化之外，也被認為是一種可由良性上皮轉化為惡性癌症的癌症前期病變。回顧研究自1985年4月至1995年3月間，93例因喉部白斑症在本部診治的病人，先依照首次喉部切片的病理所見，將病人區分為角化症（K）及角化症合併細胞異常（KWD）兩組，再依照臨床特徵，惡性變化率，治療與預後的關聯性，分別比較與研究。在比較這兩組病人當中，性別、吸煙與喝酒的習慣，並沒有統計學上的差異。K組病人的平均年齡為62歲，顯著地比KWD組病人的66.8歲年輕（p=0.006）。K與KWD組病人整體的惡性變化率分別為6.5%與25.5%，具有統計學上的差異（p=0.0024）。若病人僅作切片檢查，則82%的K組病人及25.9%的KWD病人成為正常黏膜。若病人接受進一步的手術治療，則85.7%的K組病人及60%的KWD組病人恢復為正常黏膜。本研究的結果支持，上皮異常細胞的存在，在喉部黏膜細胞癌症化的過程當中，是極為關鍵的步驟。我們認為，對於喉部黏膜的白斑病變，正確的診斷與徹底的手術切除是必要的。此外，為了預防侵犯性癌症的產生，對此類病人則須長期與小心地追蹤檢查。
關鍵字
無資料並列摘要
Precancerous lesion of larynx (laryngeal leukoplakia) represents a wide variety of distinct histologic change of laryngeal mucosa and have the capacity to progress from benign lesion to malignant cancer. From April 1985 to March 1995, 93 patients presented at our clinic with laryngeal leukoplakia are reviewed. According to the histopathological findings, patients are categorized into two groups: keratosis(K) and keratosis with dysplasia(KWD) separately. Clinical characteristics, malignant transformation rate and correlation of treatment and prognostic result are studied. There are no significant difference in gender, smoking and drinking habit of patient between K and KWD group. The mean age of K group is 62 years, significant younger than KWD group 66.8 years (p=0.006). The overall malignant transformation rate of K and KWD group are 6.5% and 25.5% respectively (p=0.0024). Supposing patients are treated solely by biopsy, 82% of K group and 25.9% of KWD group display normal mucosa. If patients receive further surgery, 85.7% of K group and 60% of KWD group recover to be normal mucosa. Our studys support that the key step of whole process of carcinogenesis of laryngeal mucosa is the presence of epithelial dysplasia. We consider that precise diagnosis and radical resection of leukoplakic lesion of larynx is rather essential. Besides, such patients should be long-term followed up carefully and regularly for the potential development of invasive carcinoma.
延伸閱讀
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