背景:喉白斑(LL)是一种白色病变,具有很高的复发和恶变可能性。目前,CO2激光已成为LL的主要手术治疗方法,治疗后的复发率和恶性转化率差异很大。
目的:我们进行了系统评价和荟萃分析,旨在评估CO2激光治疗LL病变的复发率和恶变率,并探讨复发或恶变的相关危险因素。
方法:文献检索在ProQuest,PubMed,WebofScience,OvidMedline,Embase,和Cochrane数据库。包括通过手工搜索确定的一些文章。
结果:共14篇文献和1462例患者纳入本综述。汇总结果显示,总体复发率为15%,恶变率为3%。亚组分析表明,异型增生分级不是LL复发和恶变的显著危险因素(P>0.05)。
结论:本系统综述和荟萃分析的结果表明,CO2激光是一种安全有效的用于LL切除的手术器械,导致低复发率和恶性转化。与复发或恶变相关的危险因素仍不清楚,需要进一步调查。
BACKGROUND: Laryngeal leukoplakia (LL) is a white lesion with high potential of recurrence and malignant transformation. Currently, CO2 laser has become the primary surgical treatment for LL, and the recurrence and malignant transformation rates after treatment vary widely.
OBJECTIVE: We performed a systematic
review and meta-analysis dedicated to evaluating the rates of recurrence and malignant transformation of LL lesions treated with CO2 laser and exploring relevant risk factors for recurrence or malignant transformation.
METHODS: Literature searches were conducted on ProQuest, PubMed, Web of Science, Ovid Medline, Embase, and Cochrane databases. Some articles identified through hand searching were included.
RESULTS: A total of 14 articles and 1462 patients were included in this
review. Pooled results showed that the overall recurrence rate was 15%, and the malignant transformation rate was 3%. Subgroup analysis showed that the dysplasia grade was not a significant risk factor for the recurrence and malignant transformation of LL (P > .05).
CONCLUSIONS: The results of this systematic
review and meta-analysis suggest that the CO2 laser is a safe and effective surgical instrument for the excision of LL, which yields low rates of recurrence and malignant transformation. The risk factors relevant to recurrence or malignant transformation remain unclear and require further investigation.