laryngeal neoplasms

喉肿瘤
  • 文章类型: Journal Article
    在早期喉癌的治疗中,手术(经口喉部手术(TOLS),开放部分喉手术(OPLS)和放射治疗(RT)。
    比较TOLS或RT治疗的早期喉鳞状细胞癌(LSCC)患者的肿瘤学结果。
    回顾性研究。
    三级培训和研究医院。
    参与者被分为接受TOLS和RT治疗的患者。两组在局部复发方面进行比较,区域性复发,远处转移,3年和5年总生存期(OS),无病生存率(DFS),疾病特异性生存率(DSS)和无喉切除术生存率(LFS)。
    TOLS和RT治疗对局部控制的影响,区域控制,操作系统,DFS,早期喉癌的DDS和LFS。
    261。
    平均随访时间为48(26)个月。有186例患者接受了TOLS治疗,75例患者接受了RT治疗。性别,香烟/酒精消费,肿瘤定位,前连合受累,肿瘤等级,两组的复发率和复发部位相似.5年总体来说,疾病特异性,无病和无喉切除术生存率为85.9%,88%,79.4%,TOLS组的96.3%和74.3%,76.7%,72.3%,RT组为85.2%(分别为P=.034、.065、.269、.060)。
    与RT相比,TOLS在OS和DFS上的肿瘤学结果相同且良好。前连合受累是两组DFS的统计学显著独立预后危险因素。TOLS组的5年OS率更高(P=.034)。
    回顾性,但就我们所知,这是土耳其首例患者量大,随访时间长的研究.
    UNASSIGNED: In the treatment of early stage laryngeal cancers, surgery (transoral laryngeal surgery (TOLS), open partial laryngeal surgery (OPLS) and radiotherapy (RT) are used.
    UNASSIGNED: Compare the oncological results of patients with early stage laryngeal squamous cell carcinoma (LSCC) treated with TOLS or RT.
    UNASSIGNED: Retrospective.
    UNASSIGNED: Tertiary training and research hospital.
    UNASSIGNED: The participants were divided into patients who underwent TOLS and RT treatment. The groups were compared with each other in terms of local recurrence, regional recurrence, distant metastasis, 3 and 5-year overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS) and laryngectomy-free survival rates (LFS).
    UNASSIGNED: The effects of TOLS and RT treatment on local control, regional control, OS, DFS, DDS and LFS in early stage laryngeal cancers.
    UNASSIGNED: 261.
    UNASSIGNED: The mean follow-up time was 48 (26) months. There were 186 patients who underwent TOLS and 75 patients who underwent RT treatment. Gender, cigarette/alcohol consumption, tumor localization, anterior commissure involvement, tumor grades, recurrence rates and recurrence localizations of the groups were similar. The 5-year overall, disease specific, disease free and laryngectomy-free survival rates were 85.9%, 88%, 79.4%, 96.3% in the TOLS group and 74.3%, 76.7%, 72.3%, 85.2% in the RT group (P=.034, .065, .269, .060, respectively).
    UNASSIGNED: TOLS had equal and good oncological outcomes on OS and DFS compared to RT. Anterior commissure involvement was statistically significant independent prognostic risk factor for DFS in both groups. The 5-year OS rate was greater in the TOLS groups (P=.034).
    UNASSIGNED: Retrospective, but to the best our knowledge, this is the first study in Turkey with a high patient volume and a long follow-up time.
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  • 文章类型: English Abstract
    Objective:To detect the differences in types and levels of amino acids in the peripheral serum of patients with laryngeal squamous cell carcinoma and non-tumor patients, and explore their relationship with clinical parameters of laryngeal squamous cell carcinoma as well as their clinical value in diagnosis. Methods:High-performance liquid chromatography-tandem mass spectrometry(HPLC-MS) was employed to detect the serum amino acid contents and levels of 62 patients diagnosed with laryngeal carcinoma and 141 non-tumor patients at the First Affiliated Hospital of Jinzhou Medical University between September 2018 and February 2021. The study compared the differences in 22 non-essential and essential amino acids found in the serum between the experimental group and the control group. An ROC curve and risk scoring formula of multivariate linear logic regression model was utilized to evaluate the efficiency of serum amino acids in the early diagnosis of laryngeal carcinoma. Results:There were significant differences in the contents of fourteen types of amino acids between the experimental and control groups, with thirteen amino acids showing higher levels in the experimental group(P<0.05). Seven of these amino acids were essential, including phenylalanine, threonine, leucine, valine, histidine, tyrosine, and citrulline. The other six amino acids were non-essential, including arginine, asparagine, cysteine, glycine, ornithine, and proline. Interestingly, the content of homocysteine in the experimental group was lower than that in the control group(P=0.024). Further analysis showed that patients with laryngeal squamous cell carcinoma in TNM stage Ⅰ and Ⅱ had higher serum methionine levels compared to those in stages Ⅲ and Ⅳ(P=0.026). In addition, the content of serum histidine was higher in patients with poorly differentiated squamous cell carcinoma compared to those with well-differentiated squamous cell carcinoma(P=0.041). The level of asparagine in the serum of patients with laryngeal squamous cell carcinoma older than 64 years old was lower than that in patients younger than 64 years old(P=0.033). The level of tryptophan in the serum of patients with a smoking history was lower than that in patients without a smoking history(P=0.033). The level of citrulline in the serum of patients with a history of alcohol consumption was higher than that in patients with no history of alcohol consumption(P=0.003). ROC curve analysis showed that out of the 14 different amino acids between the experimental and control groups, citrulline and cysteine were relatively effective as independent factors in the diagnosis of laryngeal squamous cell carcinoma, with an AUC of 0.856 and 0.850, respectively. Arginine was the most sensitive factor in the diagnosis of laryngeal squamous cell carcinoma(AUC=0.855). However, citrulline alone had the highest specificity(0.830) in the diagnosis of laryngeal squamous cell carcinoma, and the combination of 12 amino acids significantly improved the diagnostic efficiency of laryngeal squamous cell carcinoma, with an AUC of 0.946, sensitivity of 0.887, and specificity of 0.894. A risk score formula for a multivariate logistic regression model was established based on the differential amino acid content in the serum. The risk score of laryngeal squamous cell carcinoma group was higher than that of the non-tumor group(P<0.001). The AUC of risk score in the diagnosis of laryngeal squamous cell carcinoma was 0.953 with sensitivity and specificity of 0.957 and 0.855. Conclusion:This study found that there are differences in the contents of 14 amino acids among which 13 amino acids were increased in serum of patients with laryngeal squamous cell carcinoma, and were associated with age, clinical stage, pathological differentiation, smoking, and drinking. Combined detection of 12 amino acids can improve the diagnostic efficiency of laryngeal squamous cell carcinoma and serve as potential markers for the auxiliary diagnosis of laryngeal squamous cell carcinoma using peripheral blood samples. Additionally, the established risk score model was found to be more effective in the diagnosis of laryngeal squamous cell carcinoma, indicating its important potential value as an auxiliary diagnostic tool.
    目的:检测喉鳞状细胞癌患者与非肿瘤患者外周血清中氨基酸种类及含量差异,探讨他们与喉鳞癌各临床参数之间的关系以及在诊断中的临床价值。 方法:采用高效液相色谱-串联质谱(HPLC-MS)法检测锦州医科大学附属第一医院2018年9月-2021年2月初诊的62例喉鳞癌患者(实验组)和同时期的141例非肿瘤患者(对照组)血清22种非必需氨基酸及必需氨基酸种类与含量差异,应用ROC曲线及多元线性逻辑回归模型对差异性氨基酸在喉鳞癌早期诊断中的效能进行分析。 结果:实验组较对照组血清中有14种氨基酸含量存在差异,其中13种氨基酸含量显著高于对照组(P<0.05),包括7种必需氨基酸:苯丙氨酸、苏氨酸、亮氨酸、缬氨酸、组氨酸、酪氨酸、瓜氨酸,以及6种非必需氨基酸:精氨酸、天冬酰胺、半胱氨酸、甘氨酸、鸟氨酸、脯氨酸。而同型半胱氨酸含量明显低于对照组(P=0.024)。进一步分析表明临床早期(Ⅰ期+Ⅱ期)喉鳞癌患者血清中甲硫氨酸含量显著高于临床晚期(Ⅲ期+Ⅳ期)患者(P=0.026)。高分化鳞状细胞癌患者血清中组氨酸含量显著高于低分化鳞状细胞癌患者(P=0.041)。年龄>64岁的喉鳞癌患者血清中天冬酰胺的含量高于≤64岁的喉鳞癌患者(P=0.033),有吸烟史的喉鳞癌患者血清中色氨酸含量均低于无吸烟史患者(P=0.033),有饮酒史的喉鳞癌患者血清中瓜氨酸含量高于无饮酒史的喉鳞癌患者(P=0.003)。ROC曲线分析表明,实验组与对照组间存在差异的14种氨基酸中,除同型半胱氨酸和鸟氨酸不具备统计学意义(P>0.05),瓜氨酸和半胱氨酸作为独立因素诊断喉鳞癌的效能相对较高(AUC数值分别为0.856及0.850);而精氨酸作为单独诊断喉鳞癌因素时的灵敏度则最高(0.855);但单独使用瓜氨酸诊断喉鳞癌时其特异度最高(0.830);将12种氨基酸联合应用于检测可显著提高喉鳞癌的诊断效能,AUC为0.946,灵敏度为0.887,特异度为0.894。基于血清差异氨基酸含量建立多元线性逻辑回归模型的风险评分公式,喉鳞癌组的风险评分高于非肿瘤组(P<0.001),风险评分诊断喉鳞癌的AUC为0.953(敏感度和特异度分别为0.957和0.855)。 结论:喉鳞癌患者与非肿瘤患者比较,14种氨基酸的含量存在差异,其中13种氨基酸的含量在喉鳞癌患者血清中升高,并与年龄、临床分期、病理分化程度、吸烟以及饮酒具有相关性。联合其中12种氨基酸进行检测可提高喉鳞癌的诊断效能,具备外周血辅助诊断喉鳞癌的潜力。同时建立风险评分模型发现其对于喉鳞癌的诊断效能更高,表明该模型对于辅助诊断喉鳞癌有重要潜在价值。.
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  • 文章类型: English Abstract
    Objective:To observe the clinical effect of placing heterogeneous acellular dermal matrix membrane for laryngeal cavity wound healing after CO2 laser Type-Ⅴa cordectomy for glottic carcinoma. Methods:Thirty-five patients with bilateral vocal cord laryngeal cancer who underwent endoscopic CO2 laser surgery at the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University from March 2018 to December 2019 were selected and divided into 2 groups, including 18 patients in the study group and 17 patients in the control group. The control group was simply placed silicone tube stent, while in the study group, heterogeneous acellular dermal matrix membrane was coated with silicone tube stent. The postoperative laryngeal wound repair and clinical manifestations were observed and compared between the two groups. Results:Compared postoperative laryngeal wound after 6 months: no patients in the study group had granulation tissue, whereas 4 patients in the control group had granulation tissue; 3 patients in the study group developed moderate to severe tissue adhesion, while 9 patients in the control group; 10 patients in the control group developed 2nd to 4th degree laryngeal obstruction, compared with only 4 patients in the study group. Conclusion:The primary placement of ADM can reduce laryngeal granulation tissue and tissue adhesion after CO2 laser Type-Ⅴa cordectomy for laryngeal cancer, and may reduce the occurrence of postoperative laryngeal obstruction.
    目的:观察异种脱细胞真皮基质(acellular dermal matrix, ADM)修复膜植入对声门型喉癌CO2激光Ⅴa型声带切除术后喉腔创面修复的临床疗效。 方法:选择2018年3月-2019年12月在中南大学湘雅二医院耳鼻咽喉头颈外科接受内镜下CO2激光手术的35例双侧声带病变喉癌患者为研究对象并分为2组,其中研究组18例,对照组17例,对照组单纯植入硅胶管喉模支架,研究组则在硅胶管外衬ADM,观察2组患者术后喉腔创面的修复情况及相关临床表现。 结果:术后6个月喉腔创面比较,研究组均无肉芽组织残留,对照组4例患者有肉芽残留;研究组3例患者出现中重度喉粘连,对照组9例患者出现中重度喉粘连;对照组10例患者表现为2~4度喉梗阻,研究组仅4例出现相同情况。 结论:ADM Ⅰ期植入不仅能够减少喉癌CO2激光Ⅴa型声带切除术后喉腔肉芽、喉粘连,还可能减少术后喉梗阻的发生。.
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  • 文章类型: Journal Article
    目的:分析经口微创手术(TMIS)治疗声门上喉癌(SGLC)的肿瘤和功能结果,并探讨独立的预后因素。
    方法:纳入接受TMIS治疗的70例SGLC患者。总生存期(OS),无复发生存率(RFS),并对术后功能进行分析。
    结果:62例患者为早期阶段(Tis,T1和T2)和8例患者为T3。11例患者接受术前诱导化疗(IC)。60例患者接受经口激光显微手术(TLM),10例患者接受经口机器人手术(TORS).58名患者通过水吞咽测试获得1级评分,49例患者分0级,粗糙度,呼吸,虚弱,应变。1年、3年和5年OS均为95.450%,84.877%,和78.026%,RFS为89.167%,78.052%,和75.451%。Kaplan-Meier生存分析显示N分期和临床分期与OS相关,吸烟,临床分期,手术切缘,Ki-67指数与RFS相关。术前IC或直接手术无显著差异,TLM,或TORS。Cox分析显示,吸烟和手术切缘是RFS的独立预后因素。
    结论:阳性边缘,Ki-67指数≥40%和P53(+)和Ki-67指数≥40%是SGLC患者复发的较差因素。吸烟和手术切缘是影响复发的独立预后因素。
    OBJECTIVE: To analyze oncological and functional results of transoral minimally invasive surgery (TMIS) for supraglottic laryngeal carcinoma (SGLC), and investigate independent prognostic factors.
    METHODS: Seventy SGLC patients treated with TMIS were included. The overall survival (OS), recurrence-free survival (RFS), and postoperative functions were analyzed.
    RESULTS: Sixty-two patients were early-stage (Tis, T1, and T2) and eight patients were T3. Eleven patients received preoperative induction chemotherapy (IC). Sixty patients received transoral laser microsurgery (TLM), and 10 patients received transoral robotic surgery (TORS). Fifty-eight patients were scored Grade-1 by water swallow test, and 49 patients were scored Grade 0 by grade, roughness, breathiness, asthenia, strain. The 1, 3, and 5 year OS of all were 95.450%, 84.877%, and 78.026%, and RFS were 89.167%, 78.052%, and 75.451% respectively. Kaplan-Meier survival analysis showed N stage and clinical stage were associated with OS, smoking, clinical stage, surgical margins, and Ki-67 index were associated with RFS. There were no significant differences in preoperative IC or direct surgery, TLM, or TORS. Cox analyses showed smoking and surgical margins were independent prognosis factors for RFS.
    CONCLUSIONS: The positive margin, Ki-67 index ≥40% and P53(+)&Ki-67 index ≥40% are worse factors affecting recurrence for SGLC patients. Both smoking and surgical margins are independent prognostic factors affecting recurrence.
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  • 文章类型: Journal Article
    背景:HHLA2(人类内源性逆转录病毒-H长末端重复序列相关蛋白2)代表了最近确定的B7免疫检查点家族成员,其特征是在正常组织中表达有限,但在各种癌症类型中明显过表达。然而,精确的功能和与免疫细胞的相互作用仍然知之甚少,尤其是喉鳞状细胞癌(LSCC)。这项研究试图阐明HHLA2在人类LSCC组织的肿瘤微环境中的生物学意义,并描述HHLA2在LSCC发病机理中的临床相关性和功能作用。
    方法:通过对来自LSCC患者(n=72)的组织微阵列进行的多重免疫组织化学分析,进行分析以评估HHLA2的表达水平,CD68HLA-DRCD163-(M1巨噬细胞)的密度和空间模式,CTLA-4+CD4+FoxP3+(CTLA-4+Treg细胞),CTLA-4+CD4+FoxP3-(CTLA-4+Tcon细胞),耗尽的CD8+T细胞,和LSCC组织中终末耗尽的CD8+T细胞。进行生存分析以评估HHLA2和这些免疫检查点或免疫细胞群的预后意义。采用COX回归分析确定独立的预后因素。
    结果:Kaplan-Meier(K-M)存活曲线揭示了LSCC中HHLA2表达与总生存期(OS)之间的显著关联。HHLA2水平升高与患者生存率降低有关。表明其作为预后标志物的潜力(HR:3.230,95CI0.9205-11.34,P=0.0067)。值得注意的是,CD68+细胞(总巨噬细胞)的浸润增加,STING+CD68+HLA-DR+CD163-(STING+M1巨噬细胞),CTLA-4+CD4+FoxP3+,CTLA-4+CD4+FoxP3-,PD-1+LAG-3+CD8+T细胞,PD-1+LAG-3+TIM-3+CD8+T细胞与较差的生存结局密切相关(P<0.05)。在这些免疫细胞群的水平之间观察到明显的趋势,STING+CD68+(STING+总巨噬细胞),CD68+HLA-DR+CD163-,STING+CD68+CD163+HLA-DR-(STING+M2巨噬细胞),PD-1+LAG-3-CD8+T细胞,PD-1+TIM-3+CD8+T细胞,PD-1+LAG-3+TIM-3-CD8+T细胞与预后的关系。重要的是,多因素COX分析确定HHLA2是LSCC患者OS的独立预测因子(HR=3.86,95%CI1.08-13.80,P=0.038)。这强调了HHLA2作为预测LSCC患者预后的关键标志物的潜力。
    结论:HHLA2作为评估LSCC患者OS的一个有害的预后生物标志物出现。相对于其他免疫检查点,HHLA2对LSCC患者的预后表现出更高的预测功效。
    BACKGROUND: HHLA2 (human endogenous retrovirus-H long terminal repeat-associating protein 2) represents a recently identified member of the B7 immune checkpoint family, characterized by limited expression in normal tissues but notable overexpression in various cancer types. Nevertheless, the precise function and interaction with immune cells remain poorly understood, particularly in laryngeal squamous cell carcinoma (LSCC). This investigation endeavored to elucidate the biological significance of HHLA2 within the tumor microenvironment of human LSCC tissues and delineate the clinical relevance and functional roles of HHLA2 in LSCC pathogenesis.
    METHODS: Through multiplexed immunohistochemistry analyses conducted on tissue microarrays sourced from LSCC patients (n = 72), the analysis was executed to assess the expression levels of HHLA2, density and spatial patterns of CD68+HLA-DR+CD163- (M1 macrophages), CTLA-4+CD4+FoxP3+ (CTLA-4+Treg cells), CTLA-4+CD4+FoxP3- (CTLA-4+Tcon cells), exhausted CD8+T cells, and terminally exhausted CD8+T cells in LSCC tissues. Survival analysis was conducted to evaluate the prognostic significance of HHLA2 and these immune checkpoints or immune cell populations, employing COX regression analysis to identify independent prognostic factors.
    RESULTS: Kaplan-Meier (K-M) survival curves revealed a significant association between HHLA2 expression and overall survival (OS) in LSCC. Elevated levels of HHLA2 were linked to reduced patient survival, indicating its potential as a prognostic marker (HR: 3.230, 95%CI 0.9205-11.34, P = 0.0067). Notably, increased infiltration of CD68+ cells (total macrophages), STING+CD68+HLA-DR+CD163- (STING+M1 macrophages), CTLA-4+CD4+FoxP3+, CTLA-4+CD4+FoxP3-, PD-1+LAG-3+CD8+T cells, and PD-1+LAG-3+TIM-3+CD8+T cells strongly linked to poorer survival outcomes (P < 0.05). A discernible trend was observed between the levels of these immune cell populations, STING+CD68+ (STING+ total macrophages), CD68+HLA-DR+CD163-, STING+CD68+CD163+HLA-DR- (STING+M2 macrophages), PD-1+LAG-3-CD8+T cells, PD-1+TIM-3+CD8+T cells, and PD-1+LAG-3+TIM-3-CD8+T cells and prognosis. Importantly, multivariate COX analysis identified HHLA2 as an independent predictive factor for OS in LSCC patients (HR = 3.86, 95% CI 1.08-13.80, P = 0.038). This underscored the potential of HHLA2 as a critical marker for predicting patient outcomes in LSCC.
    CONCLUSIONS: HHLA2 emerged as a detrimental prognostic biomarker for assessing OS in LSCC patients. Relative to other immune checkpoints, HHLA2 exhibited heightened predictive efficacy for the prognosis of LSCC patients.
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  • 文章类型: Journal Article
    This paper presents a unique clinical observation of 16 years of use without replacement of a domestic voice prosthesis in a patient after laryngectomy. Long-term recurrence-free survival was achieved as a result of treatment of laryngeal leiomyosarcoma.
    В данной работе представлено уникальное клиническое наблюдение 16-летней эксплуатации без замены отечественного голосового протеза у больного после ларингэктомии. Достигнута длительная безрецидивная выживаемость в результате лечения лейомиосаркомы гортани.
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  • 文章类型: English Abstract
    The article describes our experience in developing and training an artificial neural network based on artificial intelligence algorithms for recognizing the characteristic features of benign laryngeal tumors and variants of the norm of the larynx based on the analysis of laryngoscopy pictures obtained during the examination of patients. During the preparation of data for training the neural network, a dataset was collected, labeled and loaded, consisting of 1471 images of the larynx in digital formats (jpg, bmp). Next, the neural network was trained and tested in order to recognize images of the norm and neoplasms of the larynx. The developed and trained artificial neural network demonstrated an accuracy of 86% in recognizing of benign laryngeal tumors and variants of the norm of the larynx. The proposed technology can be further used in practical healthcare to control and improve the quality of diagnosis of laryngeal pathologies.
    В статье представлен наш опыт разработки и обучения искусственной нейронной сети на основе алгоритмов искусственного интеллекта для распознавания характерных признаков образований и вариантов нормы гортани на основе анализа фотоснимков ларингоскопических картин, полученных при обследовании пациентов. В ходе подготовки данных для обучения нейросети собран, размечен и загружен датасет, состоящий из 1471 снимка гортани в цифровых форматах (jpg, bmp). Далее проведено обучение и тестирование нейросети с целью распознавания изображений нормы и новообразований гортани. Разработанная и обученная искусственная нейронная сеть продемонстрировала точность 86% в распознавании образований и вариантов нормы гортани. Предложенная технология в дальнейшем может быть использована в практическом здравоохранении для контроля и повышения качества диагностики патологии гортани.
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  • 文章类型: English Abstract
    OBJECTIVE: To evaluate the incidence of laryngeal papillomatosis (LP) and LP recurrence in adults and to determine the risk factors for the development of LP recurrence in adults in Moscow. To solve the tasks set, a survey of patients carried out, including the collection of complaints and anamnesis, a standard examination of the ENT organs, an assessment of the condition of the larynx, and a histological examination.
    METHODS: We conducted a retrospective analysis of the case histories of 299 patients with LP observed and treated at the Sverzhevsky Research and Clinical Institute of Otorhinolaryngology in the period 2010-2020.
    RESULTS: On average, over the entire study period, the prevalence of PG was 17.80%. It was found that out of 299 patients, 69.6% (n=208) had a relapse of LP. Papilloma of the larynx were more often localized in the glottis. 275 (92%) patients had a widespread form of LP. LP recurrences were significantly more common in women and in patients with an existing cicatricle process in the larynx. The relapse rate was higher in non-smokers (73.5% vs 47.8%; p<0.001). Although the recurrence rate was higher in patients with non-voice occupations (70.6% vs. 52.9%), there was no statistically significant association between relapses and the vocal professions (p=0.125).
    CONCLUSIONS: As a result of the study, a number of risk factors for laryngeal papillomatosis recurrent have been identified, and their study should be continued.
    UNASSIGNED: Оценить частоту выявления папилломатоза гортани (ПГ) и его рецидивов у взрослых, определить факторы риска развития рецидива ПГ у взрослых в Москве.
    UNASSIGNED: Провели ретроспективный анализ историй болезни 299 больных с ПГ, которые наблюдались и получали лечение на базе ГБУЗ «НИКИО им. Л.И. Свержевского» ДЗМ в 2010—2020 гг.
    UNASSIGNED: Для решения поставленных задач провели обследование пациентов, включающее сбор жалоб и анамнеза, стандартный оториноларингологический осмотр, оценку состояния гортани и гистологическое исследование. Папилломы гортани чаще локализовывались в складковом отделе гортани. Распространенная форма ПГ обнаружена у 275 (92%) пациентов. В среднем за весь период исследования частота ПГ составила 17,8%. Выявлено, что рецидив ПГ имел место у 69,6% (n=208) из 299 больных. Рецидивы ПГ чаще встречались у женщин и у пациентов с имеющимся рубцовым процессом в гортани. Частота рецидивов была выше у некурящих пациентов (73,5% по сравнению с 47,8%; p<0,001), а также у пациентов с неголосовой профессией (70,6% по сравнению с 52,9%), не было статистически значимой связи между рецидивами ПГ и голосовой профессией (p=0,125).
    UNASSIGNED: В результате исследования выявлен ряд факторов риска рецидива папилломатоза гортани, их изучение должно быть продолжено.
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  • 文章类型: Journal Article
    目的:治疗方法的变化,特征是从喉切除术转向关注器官保存方法可能导致生存率降低。我们的目标是确定北欧国家50年期间喉癌(LC)生存趋势的差异,并讨论治疗方案变化等因素的潜在影响。
    方法:1972年至2021年的五年相对生存(RS)数据来自NORDCAN数据库2.0,其中包括33,692例LC病例,其中85%被诊断为男性。在NORDCAN数据库中,年龄标准化RS是使用PoharPerme估计器和单个国际癌症生存标准权重计算的。Joinpoint回归模型用于评估RS多年来趋势的潜在变化。
    结果:尽管丹麦和挪威在1972年至2021年的5年RS中表现出增长趋势,但在芬兰和瑞典,男性的5年RS保持不变,没有任何明显的趋势。在1992-1996年至2017-2021年的30年间,丹麦的RS分别提高了9、4、13和2个百分点。芬兰,挪威,瑞典,分别。在瑞典的女性中,观察到线性负趋势,值得注意的是,从最早到最近一段时间,5年期RS下降了16个百分点。
    结论:生存趋势差异的根本原因尚不清楚。除了治疗方案的差异,其他几个因素也会影响RS,这使得RS趋势的解释具有挑战性。
    OBJECTIVE: Changes in treatment approaches, characterised by the shift from laryngectomy to a focus on organ-preserving methods may have potentially resulted in lower survival. We aim to identify differences in survival trends for laryngeal cancer (LC) in the Nordic countries over a period of 50 years, and discuss the potential impact of factors such as changes in treatment protocols.
    METHODS: Five-year relative survival (RS) data from 1972 to 2021 were obtained from the NORDCAN database 2.0 which included 33,692 LC cases, of which 85% were diagnosed among men. In the NORDCAN database, the age-standardised RS is calculated using the Pohar Perme estimator with individual International Cancer Survival Standards weights. Joinpoint regression models were used to assess potential shifts in trend over the years in RS.
    RESULTS: While Denmark and Norway demonstrated an increasing trend in 5-year RS from 1972 to 2021, in Finland and Sweden, the 5-year RS among men remained static, without any discernible significant trend. Over the 30-year period from 1992-1996 to 2017-2021, RS improved by 9, 4, 13, and 2 percentage points in Denmark, Finland, Norway, and Sweden, respectively. Among women in Sweden, a linear negative trend was observed, noticeable as a 16 percentage-point decline in 5-year RS from the earliest to the latest period.
    CONCLUSIONS: The underlying causes for the differences in survival trends remain unclear. Besides differences in treatment protocols, several other factors can affect RS making the interpretation of RS trends challenging.
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  • 文章类型: Journal Article
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