鼻腔鼻窦内翻性乳头状瘤复发的影响因素分析

Analysis of the factors influencing the recurrence of sinonasal inverted papilloma

目的探讨鼻腔鼻窦内翻性乳头状瘤复发的影响因素。方法选取60例鼻腔鼻窦内翻性乳头状瘤患者作为研究对象,分析患者的临床资料及3年随访资料,统计复发率,分析鼻腔鼻窦内翻性乳头状瘤复发的影响因素。结果60例患者中,术后复发10例(16.67%)。复发组有鼻部手术史、实施鼻侧切开、肿瘤发生部位在上颌窦、临床分级Ⅱ、Ⅲ级的患者占比高于未复发组,差异有统计学意义(P<0.05)。有鼻部手术史、实施鼻侧切开、肿瘤发生部位在上颌窦、临床分级Ⅱ、Ⅲ级均为鼻腔鼻窦内翻性乳头状瘤复发的影响因素(P<0.05)。结论鼻腔鼻窦内翻性乳头状瘤复发受多种因素影响,但肿瘤切除不彻底是其复发的根本原因。因此,疾病的治疗应通过多种影像学检查及术中内镜找到生发中心,力求整块、彻底切除瘤体。对于多次复发及恶变的患者而言,辅助放、化疗等综合治疗、术后定期复查、接受长期随访有助于预防复发。

Objective To investigate the factors influencing the recurrence of sinonasal inverted papilloma.Methods A total of 60 patients with sinonasal inverted papilloma were selected as the research objects.The clinical data and 3-year follow-up data of the patients were analyzed.The recurrence rate was calculated and the factors influencing the recurrence of sinonasal inverted papilloma were analyzed.Results Among the 60 patients,10 cases(16.67%)recurred after surgery.The proportion of patients with history of nasal surgery,perform lateral nasal incision,tumors in the maxillary sinus,and clinical gradesⅡandⅢin the recurrence group were higher than those in the non-recurring group(P<0.05).The history of nasal surgery,perform lateral nasal incision,tumors in the maxillary sinus,and clinical gradesⅡandⅢwere the influencing factors for the recurrence of sinonasal inverted papilloma(P<0.05).Conclusion The recurrence of sinonasal inverted papilloma is affected by many factors,but incomplete tumor resection is the root cause of its recurrence.Therefore,the treatment of the disease should be through a variety of imaging examinations and intraoperative endoscopic to find the germinal center,and strive to remove the tumor in one piece and completely.For patients with multiple recurrences and malignant transformations,adjuvant radiotherapy,chemotherapy and other comprehensive treatment,regular postoperative review,and long-term follow-up are help to prevent recurrence.