成人喉乳头状瘤复发的相关因素研究

目的 :研究成人喉乳头状瘤复发的相关因素。方法 :收集成人喉乳头状瘤复发标本 5 0例 ,另选 10例炎症病变黏膜组织作为对照。应用SP法检测石蜡标本中耐药基因胎盘型谷胱甘肽 S 转移酶 (GST π)、DNA拓朴酶Ⅱ (TopoⅡ )、P 糖蛋白 (Pgp)和Ki 6 7、血管内皮生长因子 (VEGF)的表达 ,并用形态计量方法检测肿瘤内微血管密度 (MVD) ,对所得的各项指标进行统计学分析。结果 :①耐药基因Pgp、GST π和TopoⅡ的表达与年龄、性别、肿瘤大小及肿瘤复发无显著相关 (P >0 .0 5 )。②Ki 6 7在复发肿瘤与非复发肿瘤组织之间差异有统计学意义 (P <0 .0 1)。多元回归分析显示该指标是肿瘤复发的独立危险因素之一 ,以 39%为分界点 ,大于 39%者容易复发。③MVD >19(× 2 0 0 )的成人喉乳头状瘤比 <19的成人喉乳头状瘤容易复发。结论 :用Cox 逐步回归模型进行多因素分析 ,筛选出了与成人喉乳头状瘤复发有密切关系的 5个指标 :Ki 6 7阳性率是最重要的复发因子 ,其次为MVD ,而肿瘤耐药因子Pgp、TopoⅡ、GST π无明显意义。

Multivariate analysis of the parameters related to recurrence of laryngeal papilloma in adult

OBJECTIVE: To investigate the clinical and pathological characteristics of astrocytoma and the factors related to pathological gradings as well as recurrence in laryngeal papilloma in adult. METHOD: Fifty samples from patients were selected and 10 cases of normal tissue or inflammation tissue were used as control group. The expression of Pgp, GST-pi, Topo II and Ki-67 and VEGF by immunohistochemical stain and the microvessel density by morphometry were studied. RESULT: (1) The positive rates of Pgp, GST-pi and Topo II were not correlated with the age, sex, tumor size and the recurrence (P > 0.05). (2) Both recurrent tissue and current tissue showed various positivity for Ki-67. The difference were significant (P < 0.01). Taking 39% of Ki-67 expression as threshold, there was significant difference between two curves indicating favorable recurrence in the tumor group respectively (P < 0.01). (3) Microvascular changes,such as the density of blood vessels demonstrated significantly difference between the two tumor group (P < 0.01). An average vessel count of more than 19 (x 200) suggested an easier recurrence. CONCLUSION: Use of the cox-regression model in multivariate analysis shows that there are five parameters closely related to the recurrence of laryngeal papilloma in adult, of which the Ki-67 is the most critical factor, second the microvessel density, while Pgp, Topo II and GST-pi in tumor are independent favorable factors for laryngeal papilloma of adult.