声带白斑124例临床及病理分析

Clinical and Pathological Analysis for 124 Cases of Vocal Cord Leukoplakia

目的探讨声带白斑的临床表现和病理特征及相关因素。方法回顾性分析2006年1月至2008年12月收治的124例声带白斑患者的临床资料,患者均于全身麻醉下行显微支撑喉镜下声带白斑切除术,术后切除的病变组织送病理检查。结果 124例声带白斑患者中,男120例,女4例;年龄29～84岁,平均49.65±10.13岁;有长期吸烟史者89例(71.77%,89/124),长期饮酒者67例(54.03%,67/124);双侧声带前中部病变75例(60.48%,75/124),单侧声带前中部病变29例(23.38%,29/124);病理检查显示:黏膜慢性炎症10例(8.06%),鳞状上皮增生88例(70.96%),黏膜轻度异型增生6例(4.84%),中度异型增生5例(4.03%),重度异型增生5例(4.03%),原位癌6例(4.84%),浸润癌4例(3.23%)。结论声带白斑以男性多见,长期烟酒嗜好可能是主要病因之一,其病变性质以病理诊断为依据,对病理检查提示有异型增生者需密切随诊观察。

Objective To investigate the clinical and pathological features and related factors of vocal cord leukoplakis. Methods One hundred and twenty--four cases of vocal cord leukoplakia from January 2006 to December 2008 were analyzed. All the patients had undergone the surgery of vocal cord leukoplakia resection in retaining laryngoscope under general anesthesia with the specimens pathological examination. Results There were 120 males and 4 females in this study, the age ranged from 29 to 84 years,with the mean age of 49.65±10.13 years old. The causes of 89 （71. 77%） cases were long--term smoking, while the cause of 67 （54.03%） cases were drinking. 60.48% of the lesions were located in the forepart to middle part of the bilateral vocal cord, while 23.4% of the lesions were unilateral. The results of pathological examination showed chronic mucosal inflammation in 10 cases （8.06%） ,squamous epithelial hyperplasia in 88 cases （70. 96%）, mild dysplasia in 6 cases （4. 84%）, moderate dysplasia in 5 cases （4.03%）, severe dysplasis in 5 cases （4.03%） ,carcinoma in situ in 6 cases （4.84%） ,and inva- sire carcinoma in 4 cases （3.23%）. Conclusion Vocal cord leukoplakia is a predominantly male disease. Long--term smoking and drinking is one of common causes. Therefore,the final diagnosis of vocal cord leukoplakia relies on pathology. It is necessary to follow up closely for the dysplasia cases