Analysis on the prognosis of malignant transformation of sinonasal inverted papilloma
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摘要: 目的:总结鼻腔鼻窦内翻性乳头状瘤(SNIP)恶变患者的临床特征和治疗方法,探讨影响其预后的因素。方法:回顾性分析35例SNIP恶变患者的临床资料,采用Kaplan-Meier法、Log-rank单因素和Cox多因素回归模型法分析不同年龄、性别、发病部位、病理特征、临床分期以及治疗方式对SNIP恶变患者预后的影响并进行比较。结果:SNIP恶变患者5年累计生存率为68.6%,经Kaplan-Meier法单因素分析显示,SNIP恶变患者的临床分期、病理特征及治疗方式对患者的5年生存率有影响(均P<0.05),而性别、年龄、发病部位3个因素对5年生存率无影响(均P>0.05)。Cox多因素分析显示影响SNIP恶变患者生存率的独立危险因子是临床分期和治疗方式(P值分别为0.019和0.006)。结论:临床分期和治疗方式是影响SNIP恶变患者预后的重要因素。病理分化程度可作为判断SNIP恶变患者预后的辅助指标。对SNIP恶变患者行鼻内镜手术或包含手术的综合治疗可以获得较好的疗效。Abstract: Objective: To summarize the clinical characteristics and treatments of patients with malignant transformation of sinonasal inverted papilloma(SNIP),and to explore the factors influencing the prognosis of malignant SNIP. Method: To retrospectively analyze the clinical data of 35 patients with malignant SNIP.The prognosis affected by age, gender, pathogenetic locations, pathology, clinical stages and treatments were analysed using Kaplan Meier,Log rank and Cox method.Result: In our research,5 years survival rate was 68.6% in malignant SNIP.There were 3 factors effecting the 5 years survival rate of malignant SNIP: clinical staging,histopathological features and treatments while gender,age,disease location,and percentage of the malignant cell in the entire tumor tissue had no effect on overall survival rate. Clinical staging and treatment were the independent factors that influenced the prognosis of malignant SNIP (P value was 0.019 and 0.006).Conclusion: Risk factors that independently influence the survival of patients with malignant SNIP were the clinical staging and treatment. The degree of histopathological features can be the secondary indicator to judge the prognosis of malignant SNIP. endoscopic surgery or comprehensive therapy performed on patients properly is therapeutically effective.
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Key words:
- papilloma,inverted /
- malignant /
- prognosis /
- survival rate
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