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在分类系统和临床决策的背景下,中度喉发育不良
Flurin Mueller-Diesing1, Manuel Stöth1, Elena Ludwig1
1Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany.
The Laryngoscope
|April 21, 2025
概括
带有中度发育不良的声白血症具有很高的恶性转变率,支持其被归类为高度发育不良. 这就需要临床管理,类似于严重的发育不良和 carcinoma in situ.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 头部和部手术 头部和部手术
- 病理学 病理学 病理学
背景情况:
- 发声白血病的预后具有挑战性.
- 2017年世界卫生组织分类引入了喉前体病变的两级分级系统,将中度发育不良升级为高度发育不良.
研究的目的:
- 为了回顾性地分析喉白血症的恶性转变率,基于失生症等级.
- 评估2017年世卫组织分类对临床管理的影响.
主要方法:
- 对392名患有喉白血症活检的患者进行分析.
- 以后回顾对组织病理学诊断和局部化的回顾.
- 计算恶性转变率和转变的时间.
主要成果:
- 轻度发育不良的恶性转变率较低 (6%),但中度发育不良 (9%),严重发育不良 (41%) 和 carcinoma in situ (CIS) (43-55%) 的高.
- 恶性转变的时间差异很大 (0.1-10.8年) 并没有显著依赖于初始诊断.
结论:
- 数据支持将中度发育不良分类为高度发育不良,与2017年世卫组织分类保持一致.
- 中度发育不良的临床治疗应包括组织学控制的切除,类似于严重发育不良和CIS.
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