儿童喉乳头状瘤不同时期的解剖分布特点

姚俊吉; 康一; 贾欢; 张治华; 汪照炎; 黄琦; 施俊; 吴皓

doi:10.13201/j.issn.2096-7993.2020.12.008

儿童喉乳头状瘤不同时期的解剖分布特点

- 1.
  上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科(上海，200011)
- 2.
  上海交通大学医学院耳科学研究所
- 3.
  上海市耳鼻疾病转化医学重点实验室

详细信息

通讯作者: 施俊，E-mail：shijun6898@163.com

中图分类号: R739.65

收稿日期: 2020-05-15

刊出日期: 2020-12-05

Distribution of juvenile laryngeal papilloma in different stages

- 1.
  Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China
- 2.
  Ear Institute, Shanghai Jiao Tong University School of Medicine
- 3.
  Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases

More Information

Corresponding author: SHI Jun, E-mail: shijun6898@163.com

Received Date: 15 May 2020

Publish Date: 05 December 2020

摘要

摘要: 目的分析儿童喉乳头状瘤(JLP)的解剖分布、肿瘤范围等特点，总结初发与复发患儿肿瘤解剖分布的相同点及差异。方法对2011-01-2018-12就诊于上海交通大学医学院耳科学研究所的65例JLP患儿的临床资料进行回顾性分析。参考Derkay评分表将喉部划分11个解剖亚区进行统计。结果初发患儿累及(2.9±1.3)个解剖亚区；复发患儿累及(3.1±1.5)个解剖亚区。初发和复发的JLP最常累及的喉部解剖亚区均为声带、前连合及室带；最少累及的亚区均为声门下、声门后及杓会厌皱襞。但复发后声门下(P=0.038)或气管受累(P=0.007)的可能性显著高于初发。结论初发与复发患儿的解剖分布存在差异，可能与JLP倾向于在适宜HPV存活的区域复发，或与术区微病灶残留有关。
- 儿童 /
- 喉肿瘤 /
- 乳头状瘤 /
- 人类乳头状瘤病毒
Abstract: Objective To study the anatomical distribution and tumor extent of juvenile laryngeal papilloma(JLP), and to sum up the similarity and difference in distribution between initiatial and recurrent tumor.Method Data of 65 patients with JLP who were admitted to the Ear Institute, School of Medicine, Shanghai Jiao Tong University from January 2011 to December 2018 were retrospectively analyzed. The RRP tumor assessment method proposed by Derkay et al. was referred to, in which larynx was divided in to 11 anatomical sites.Result 2.9±1.3 Laryngeal anatomical sites were involved in patients with initial tumor, while that was 3.1±1.5 in patients with recurrent tumor. The most common sites were true vocal fords, anterior commissure and false vocal fords in both group; and the least ones were subglottis, posterior glottis and ary-epiglottic fold. However, subglottis(P=0.038) and trachea(P=0.007) were more likely to be involved in recurrent tumor, with statistical differences.Conclusion There were differences in distribution of JLP between initial and recurrent tumor, which might be the result of suitable areas for HPV survival or micro-lesion of residual tumor.
- child /
- laryngeal neoplasms /
- papilloma /
- human papillomavirus

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表 1 肿瘤累及解剖亚区例次(%)

解剖部位	初发(n=65)	复发(n=109)
喉
会厌	12(18.5)	26(23.9)
杓会厌皱襞(左)	6(9.2)	11(10.1)
杓会厌皱襞(右)	10(15.4)	16(14.7)
室带(左)	15(23.1)	25(22.9)
室带(右)	18(27.7)	29(26.6)
声带(左)	44(67.7)	72(66.1)
声带(右)	37(56.9)	66(60.6)
前连合	32(49.2)	54(49.5)
声门后	8(12.3)	13(11.9)
声门下	5(7.7)	21(19.3)¹⁾
其他	4(6.2)	9(8.3)
气管	1(1.5)	15(13.8)¹⁾
与初发比较，¹⁾P < 0.05。

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表 2 JLP肿瘤累及范围

组别	共累及喉部亚区/个	平均累及喉部亚区/个	单发病灶/例次(%)	多发病灶/例次(%)
初发(n=65)	191	2.9±1.3	13(20.0)	52(80.0)
复发(n=109)	342	3.1±1.5	16(14.7)	93(85.3)
合计	533	3.1±1.4	29(16.7)	145(83.3)

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