鼻腔鼻窦内翻性乳头状瘤恶变7例临床分析

Clinical Features of 7 Patients with Malignant Transformation of Sinonasai Inverted Papilloma

【目的】鼻腔鼻窦内翻性乳头状瘤是一类少见的良性肿瘤，少部分病例可以发生恶变。迄今为止，有关该病恶变的临床报道甚少。本文旨在总结分析7例鼻腔鼻窦内翻性乳头状瘤恶变病例的临床特点、治疗及疗效。【方法】回顾性分析2000年1月至2008年6月在本院治疗的鼻腔鼻窦内翻性乳头状瘤及恶变患者的临床资料。【结果】7例恶变病例占我院同期鼻腔鼻窦内翻性乳头状瘤的22．6％（7／31）。7例肿瘤恶变患者均为单侧发病；年龄45～70岁；男女比例为2：5；2例接受了鼻内镜肿瘤切除术，2例鼻侧切开肿瘤切除术，1例面中部掀翻术，1例上颌骨次全切除术，1例颅面联合手术，其中手术后给予辅助放射治疗3例；除1例失随访，2例死亡肿瘤复发外，余4例患者均无瘤生存至今。3年、5年生存率分别为80％、40％。【结论】鼻腔鼻窦内翻性乳头状瘤恶变患者应采取积极彻底的手术切除，必要时辅以放、化疗。

[Objective] To summarize with malignant transformation of sinonasal the clinical features, treatment and inverted papilloma. [Methods] The e curative results of 7 patients clinical data of patients with sinonasal inverted papilloma and malignant transformation in our hospital from Jan. 2000 to Jun. 2008 were ret- rospectively analyzed. [Results] The 7 patients with malignant transformation of sinonasal inverted papilloma accounted for 22.6% （7/31） of all the patients diagnosed as sinonasal inverted papilloma simultaneously in our hospital. The tumor in these 7 patients occurred in unilateral sinonasal. The 7 patients＂ age was 45-70 years old and the female to male ratio was 2 - 5. Among them, 2 received tylectomy with endoscope, 2 lateral rhino- tomy, 1 craniofacial surgery, 1 partial maxillectomy and 1 extended sublabial incision combined with endoscope. Three patients of them were given radiation therapy after operation. Except 1 patient lost follow up and 2 patients died of recurrence, all the rest 4 patients were alive without tumor until now. The 3- and 5-year survival rate was 80% and 40%, respectively. [Conclusion] Patients with malignant transformation of sinonasal inverted papilloma should be treated with active and thorough excision, and assisted with postoperative radiation or chemotherapy when needed.