20例小儿喉乳头状瘤治疗体会

目的　探讨小儿喉乳头状瘤的疗效。方法　 2 0例患儿均于支撑喉镜下以手术方法彻底切除肿瘤 ,其中单纯手术 (Ⅰ组 ) 11例 ,手术 +微波治疗 (Ⅱ组 ) 6例 ,术后以干扰素治疗 (Ⅲ组 ) 3例。结果　总治愈率 60 % ,Ⅰ组、Ⅱ组、Ⅲ组治愈率分别为 :45 .4%、83 .3 %、66.7%。Ⅱ组治愈率高于Ⅰ组 (P <0 .0 5 )。结论　术后以微波处理创面可提高手术治疗率。     

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目的 探讨乳腺导管内乳头状瘤(intraductal papillomas，IP)癌变的临床表现、生物学行为、诊断、治疗及预后。方法 对1980年1月至2001年12月间7例IP癌变病人临床资料进行回顾性分析。结果 7例IP癌变占同期113例IP的5．19％，术前均未能确诊，5例术中冰冻考虑IP癌变。结论 IP有癌变潜能，其癌变者术前确诊困难，术中冰冻对诊断治疗意义重大，应重视术后随访。     

Laryngeal papillomas: the epidemiology in a Danish subpopulation 1965–1984

The incidence rate of laryngeal papillomas in a Danish subpopulation (approximately 2.8 million inhabitants) was 3.84 × 10^-6 per year in the period 1968–1984. For juvenile papillomas the incidence rate was 3.62 × 10^-6, compared with 3.94 × 10^-6 for laryngeal papillomas of adult onset. When comparing different time periods a significantly low incidence was found in the time 1965–1968, while the incidence remained constant in 1969–1984. The low incidence rate in the early period may be real, but selectional bias may have played a part. It is in general anticipated that maternal genital HPV-infections may serve as an HPV-reservoir, and that juvenile laryngeal papilloma is a result of HPV transmission from the mother to the child during birth. In the period in question cervical HPV-infections have been recorded with increasing frequency in younger women, indicating that the prevalence is rising. However, this is not reflected in the incidence of laryngeal papillomas.     

Prognostic value of clinical findings in histologically verified adult-onset laryngeal papillomas

A retrospective study of adult-onset laryngeal papilloma was performed to clarify whether any clinical features at the time of diagnosis could predict its course. All patients had a histologically confirmed diagnosis of laryngeal papillomas and were treated at Helsinki University Hospital between 1975 and 1994. Those with adult-onset disease and follow-up exceeding 1 year (n = 74) entered the study. Based on the case records surveyed, results suggested two risk factors for frequent laryngeal procedures: young age at onset of papilloma and a lesion extending to the anterior third of the vocal folds. It was not possible to predict the course of the disease by such clinical findings as symptoms or size or number of primary papilloma lesions. As regards the recurrence of disease, the classic division of adult-onset laryngeal papilloma into solitary and multiple type was not found to be clinically relevant.     

Multiple papillomas of the breast: Is current management adequate?

Multiple papillomas (MP) are subject to debate in terms of their clinical and pathological significance and management. To date the ideal management is still not well established. The Royal Perth Hospital Multidisciplinary Breast Service has prospectively accrued clinical and pathological data on over 9000 patients since 1994. The database was interrogated and all pathology reports retrospectively reviewed. A total of 23 cases with the diagnosis of MP were retrieved from the database between 1994 and 2004. Of these 23 cases, 13 (56.5%) were diagnosed by core biopsy, nine (39.1%) on excision biopsy, and one (4.4%) on a mastectomy specimen. The average age of patients was 56.4 years (range 44-74 years). The average duration of follow up is 4.1 years (range 1-10 years). In our series a close association with malignancy was noted for MP, which was also associated with a spectrum of proliferative breast disease. Contemporary guidelines should be developed for this controversial condition. We recommend that all patients with MP, especially when associated with atypia, undergo wide excision of the lesion with clear margins of at least 10mm and that these patients be monitored closely with annual imaging.     

Tumor-specific and gender-specific pre-vaccination distribution of human papillomavirus types 6 and 11 in anogenital warts and laryngeal papillomas: a study on 574 tissue specimens

Anogenital warts and laryngeal papillomas are two most important benign tumors etiologically linked with HPV. In the study, which included both the largest number of laryngeal papilloma tissue specimens (152 specimens from 152 patients) to date and the largest number of prospectively collected and histologically confirmed tissue specimens of anogenital warts obtained from both genders (422 specimens from 315 patients), HPV DNA was detected in 413/422 (97.9%) of anogenital warts and 139/152 (91.4%) of laryngeal papillomas. HPV‐6 and/or HPV‐11 were detected in 291/315 (92.4%) patients with anogenital warts and in 138/152 (90.8%) patients with laryngeal papillomas, indicating that the great majority of both tumors could be prevented with prophylactic quadrivalent vaccine. The HPV‐6 gender‐specific distribution in both anogenital warts and laryngeal papillomas was not statistically significant. In contrast, HPV‐11 was found almost three times more often in males than in females with anogenital warts (16.5% vs. 6.3%; P = 0.008), with a gender neutral HPV‐11 type distribution in laryngeal papillomas. The overall HPV DNA prevalence in anogenital warts was significantly different from that in laryngeal papillomas (97.1% vs. 91.4%; P = 0.01). In the first comparison of the HPV‐6/HPV‐11 type‐specific distribution between patients suffering from anogenital warts and laryngeal papillomas with the same geographic and ethnic background, a significant imbalance in tumor‐specific distribution of HPV‐6 and HPV‐11 was identified: HPV‐6 was statistically more often present in anogenital warts than in laryngeal papillomas (79.0% vs. 59.2%; P = 0.000013), whereas HPV‐11 was statistically more frequent in laryngeal papillomas than in anogenital warts (28.9% vs. 12.4%; P = 0.00003). J. Med. Virol. 84: 1233–1241, 2012. © 2012 Wiley Periodicals, Inc.     

鞍区原发性脉络丛乳头状瘤临床病理观察

目的探讨鞍区原发性脉络丛乳头状瘤的临床病理特征。方法对1例原发于鞍区的脉络丛乳头状瘤的影像学、组织病理学和免疫组化特征进行研究,结合文献讨论其临床病理特征及鉴别诊断。结果磁共振成像显示蝶鞍增大,其内可见团块状肿块,侵及鞍上池;脑室系统无异常。内镜经鼻蝶入路行肿物切除术。镜下观察可见肿瘤组织类似于正常脉络丛,呈乳头状结构,由单层或假复层柱状肿瘤上皮细胞围绕纤维血管轴形成。肿瘤细胞异型性小,细胞核圆或卵圆形,位于上皮基底部。免疫组化显示肿瘤细胞CK-pan、vimtentin、EMA和TTF-1(+),而S-100蛋白、神经胶质酸性蛋白、Syn和嗜铬粒蛋白(-)。结论原发于鞍区的脉络丛乳头状瘤非常罕见,影像学易与垂体腺瘤等相混淆。明确诊断依赖于病理组织学观察及免疫组化标记。外科手术完整切除可治愈。