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目的 :探讨声带粘膜白斑的分型及其与癌变的关系。方法 :32例 (38侧 )中 ,14例行喉裂开声带粘膜剥皮术 ,其中 2例在显微镜下用下唇粘膜修补创面 ;18例在显微支撑喉镜下行声带粘膜剥皮术。结果 :全组病例随访 2～ 7年。单纯白斑 18例 ,无一例癌变 ;白斑伴轻度不典型增生 6例 ,有 2例发生癌变 (33% ) ;白斑伴中度和重度不典型增生各 4例 ,各有 3例发生癌变 (75 % )。各种不典型增生的癌变率差异无显著性 (P >0 .0 5 )。支撑喉镜下与喉裂开声带粘膜剥皮术 ,均有癌变发生 ,二者差异无显著性。结论 :单纯白斑可以治愈。若同时伴有任何不典型增生病变都要引起高度重视 ,密切随访。两种术式的选择对疗效无影响。
Objective: To investigate the classification of vocal cord leukoplakia and its relationship with carcinogenesis. Methods: Of the 32 cases (38 sides), 14 cases underwent acoustic rupture of the mucosa with throat rupture. Among them, 2 cases underwent repair of the wound under the microscope with the lower lip mucosa and 18 cases underwent the vocal cord mucosal dissection in the microscopic support laryngoscope. Results: All cases were followed up for 2 to 7 years. There were 18 cases of simple leukoplakia and no case of carcinomatosis. Six cases of leukoplakia with mild dysplasia and two cases of carcinomatosis (33%), 4 cases of leukoplakia with moderate and severe dysplasia, and 3 cases of carcinomatosis (75 cases) %). There was no significant difference in the rates of atypical hyperplasia (P> 0.05). Both laryngoscopy and laryngeal rupture open mucosal stripping, both cancerous lesions occurred, the difference was insignificant. Conclusion: Simple white spots can be cured. If accompanied by any atypical hyperplasia lesions have caused great attention, close follow-up. The choice of two procedures has no effect on the efficacy.