山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 25-30.doi: 10.6040/j.issn.1673-3770.1.2019.029

• 研究进展 • 上一篇    下一篇

喉癌前病变的病因、分子机制和处理策略

申宇鹏,宋琦,李晓明*()   

  1. 联勤保障部队第980医院/白求恩国际和平医院 耳鼻咽喉头颈外科,河北 石家庄 050082
  • 收稿日期:2019-05-10 出版日期:2019-07-16 发布日期:2019-07-22
  • 通讯作者: 李晓明 E-mail:xmlmo@126.com

Etiology, molecular mechanisms, and treatment strategies of precancerous laryngeal lesions

Yupeng SHEN,Qi SONG,Xiaoming LI*()   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Bethune Peace Hospital, Shijiazhuang 050082, Hebei, China
  • Received:2019-05-10 Online:2019-07-16 Published:2019-07-22
  • Contact: Xiaoming LI E-mail:xmlmo@126.com

摘要:

喉癌前病变是指临床表现具有恶变潜能的喉部病变,由多种临床表现、病理形态和生物学特性类似的疾病组成。常见喉癌前病变有喉角化症、慢性肥厚性喉炎、喉乳头状瘤等。喉癌前病变有多种致病相关因素,在其发生、发展的过程中,多种分子调节机制参与进展或影响预后。目前临床针对喉癌前病变的治疗策略,以个体化手术方案为主,预防和阻断喉癌前病变的致病因素,是临床防治工作的努力方向。

关键词: 喉癌前病变, 病因, 分子机制, 治疗结局

Abstract:

Laryngeal precancerous lesions refer to several types of laryngeal lesions with malignant potential, which present with similar clinical manifestations, pathological features, and biological characteristics. Common laryngeal precancerous lesions include laryngeal keratosis, chronic hypertrophic laryngitis, papilloma of larynx, etc. There are many pathogenic factors associated with laryngeal precancerous lesions. The prognosis is dependent on where the lesion occurs and how it develops, as there are various molecular mechanisms involved in the regulative progress. The clinical treatment strategy for laryngeal precancerous lesions depends on an individualized surgical plan. Future clinical research will focus on efforts to prevent and block the pathogenic factors of laryngeal precancerous lesions.

Key words: Laryngeal precancerous lesion, Etiology, Molecular mechanism, Treatment outcome

中图分类号: 

  • R739.6
1 Ferlito A , Devaney KO , Hunt JL , et al. Some considerations on the WHO histological classification of laryngeal neoplasms[J]. Adv Ther, 2019, 36 (7): 1511- 1517.
doi: 10.1007/s12325-019-00978-7
2 Hellquist H , Cardesa A , Gale N , et al. Criteria for grading in the Ljubljana classification of epithelial hyperplastic laryngeal lesions. A study by members of the working group on epithelial hyperplastic laryngeal lesions of the European society of pathology[J]. Histopathology, 1999, 34 (3): 226- 233.
doi: 10.1046/j.1365-2559.1999.00581.x
3 Thompson L . World Health Organization classification of tumours: pathology and genetics of head and neck tumours[J]. Ear Nose Throat J, 2006, 85 (2): 74.
doi: 10.1177/014556130608500201
4 Mehlum CS , Larsen SR , Kiss K , et al. Laryngeal precursor lesions: Interrater and intrarater reliability of histopathological assessment[J]. Laryngoscope, 2018, 128 (10): 2375- 2379.
doi: 10.1002/lary.27228
5 Weller MD , Nankivell PC , McConkey C , et al. The risk and interval to malignancy of patients with laryngeal dysplasia; a systematic review of case series and meta-analysis[J]. Clin Otolaryngol, 2010, 35 (5): 364- 372.
doi: 10.1111/j.1749-4486.2010.02181.x
6 王春雨, 张芬, 王贝贝, 等. 喉白斑32例临床诊治分析及再认识[J]. 山东大学耳鼻喉眼学报, 2018, 32 (5): 114- 116.
doi: 10.6040/j.issn.1673-3770.0.2018.338
WANG Chunyu , ZHANG Fen , WANG Beibei , et al. Clinical diagnosis and treatment of 32 cases of vocal cord leukoplakia[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32 (5): 114- 116.
doi: 10.6040/j.issn.1673-3770.0.2018.338
7 Trivedi S , Rosen CA , Ferris RL . Current understanding of the tumor microenvironment of laryngeal dysplasia and progression to invasive cancer[J]. Curr Opin Otolaryngol Head Neck Surg, 2016, 24 (2): 121- 127.
doi: 10.1097/MOO.0000000000000245
8 Cikojević D , Gluncić I , Klancnik M . Cigarette smoking and progression of laryngeal lesions[J]. Coll Antropol, 2010, 34 (Suppl 1): 45- 48.
9 Leopardi G , Serafini G , Simoncelli C , et al. Ki67 and p53 in laryngeal epithelial lesions: correlations with risk factors[J]. Acta Otorhinolaryngol Ital, 2001, 21 (4): 243- 247.
10 Jeannon JP , Soames JV , Aston V , et al. Molecular markers in dysplasia of the larynx: expression of cyclin-dependent kinase inhibitors p21, p27 and p53 tumour suppressor gene in predicting cancer risk[J]. Clin Otolaryngol, 2004, 29 (6): 698- 704.
doi: 10.1111/j.1365-2273.2004.00859.x
11 郦振伟, 周水洪. 咽喉反流和喉癌前病变[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52 (8): 637- 639.
doi: 10.3760/cma.j.issn.1673-0860.2017.08.021
LI Zhenwei , ZHOU Shuihong . Laryngopharyngeal reflux disease and laryngeal precancerous lesions[J]. Chin J Otorhinolaryngol Head Neck Surg, 2017, 52 (8): 637- 639.
doi: 10.3760/cma.j.issn.1673-0860.2017.08.021
12 Lewin JS , Gillenwater AM , Garrett JD , et al. Characterization of laryngopharyngeal reflux in patients with premalignant or early carcinomas of the larynx[J]. Cancer, 2003, 97 (4): 1010- 1014.
doi: 10.1002/cncr.11158
13 Hobbs CG , Birchall MA . Human papillomavirus infection in the etiology of laryngeal carcinoma[J]. Curr Opin Otolaryngol Head Neck Surg, 2004, 12 (2): 88- 92.
doi: 10.1097/00020840-200404000-00006
14 Davids T , Muller S , Wise JC , et al. Laryngeal papillomatosis associated dysplasia in the adult population: an update on prevalence and HPV subtyping[J]. Ann Otol Rhinol Laryngol, 2014, 123 (6): 402- 408.
doi: 10.1177/0003489414526848
15 Liu B , Lu Z , Wang P , et al. Prevalence of high-risk human papillomavirus types (HPV-16, HPV-18) and their physical status in primary laryngeal squamous cell carcinoma[J]. Neoplasma, 2010, 57 (6): 594- 600.
doi: 10.4149/neo_2010_06_594
16 Sadri M , McMahon J , Parker A . Laryngeal dysplasia: aetiology and molecular biology[J]. J Laryngol Otol, 2006, 120 (3): 170- 177.
doi: 10.1017/S0022215105005360
17 吴俊福, 周佳青. 喉癌及喉良性病变中HPV不同亚型的检测[J]. 现代肿瘤医学, 2012, 20 (9): 1813- 1816.
doi: 10.3969/j.issn.1672-4992.2012.09.16
WU Junfu , ZHOU Jiaqing . Detection of different type of human papillomavirus in benign, premalignant and malignant lesions of the larynx[J]. J Mod Oncol, 2012, 20 (9): 1813- 1816.
doi: 10.3969/j.issn.1672-4992.2012.09.16
18 Nankivell P , Weller M , McConkey C , et al. Biomarkers in laryngeal dysplasia: a systematic review[J]. Head Neck, 2011, 33 (8): 1170- 1176.
doi: 10.1002/hed.21592
19 Braut T , Kujundzić M , Vukelić J , et al. Gene amplification of epidermal growth factor receptor in atypical glottic hyperplasia[J]. Coll Antropol, 2012, 36 (Suppl 2): 87- 91.
20 Anghelina F , Ioniǎ E , Popescu CF , et al. Clinical, morphological and immunohistochemical aspects in laryngeal premalignant lesions[J]. Revue Roumaine De Morphol Et Embryol, 2006, 47 (2): 169- 174.
21 Li XM , Shen YP , Di B , et al. Biological and clinical significance of p75NTRexpression in laryngeal squamous epithelia and laryngocarcinoma[J]. Acta Oto - Laryngol, 2012, 132 (3): 314- 324.
doi: 10.3109/00016489.2011.639086
22 Rey Caro DG , Rey Caro EP , Rey Caro EA . Chromoendoscopy associated with endoscopic laryngeal surgery: a new technique for treating recurrent respiratory papillomatosis[J]. J Voice, 2014, 28 (6): 822- 829.
doi: 10.1016/j.jvoice.2014.02.006
23 Englhard AS , Betz T , Volgger V , et al. Intraoperative assessment of laryngeal pathologies with optical coherence tomography integrated into a surgical microscope[J]. Lasers Surg Med, 2017, 49 (5): 490- 497.
doi: 10.1002/lsm.22632
24 Davaris N , Voigt-Zimmermann S , Roessner A , et al. Narrow band imaging for evaluation of laryngeal mucosal lesions[J]. HNO, 2017, 65 (6): 527- 542.
doi: 10.1007/s00106-017-0336-x
25 陈立晓, 蒋锐, 於子卫. 窄带成像技术在咽喉肿瘤诊治中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32 (6): 104- 108.
doi: 10.6040/j.issn.1673-3770.0.2018.174
CHEN Lixiao , JIANG Rui , YU Ziwei . Narrow-band imaging in diagnosis and treatment of tumors of the pharynx and larynx[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32 (6): 104- 108.
doi: 10.6040/j.issn.1673-3770.0.2018.174
26 Kum RO , Ozcan M , Baklaci D , et al. Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions[J]. Asian Pac J Cancer Prev, 2014, 15 (17): 7351- 7355.
doi: 10.7314/apjcp.2014.15.17.7351
27 Cosway B , Paleri V . Laryngeal dysplasia: an evidence-based flowchart to guide management and follow up[J]. J Laryngol Otol, 2015, 129 (6): 598- 599.
doi: 10.1017/S0022215115000833
28 van Hulst AM , Kroon W , van der Linden ES , et al. Grade of dysplasia and malignant transformation in adults with premalignant laryngeal lesions[J]. Head Neck, 2016, 38 (Suppl 1): E2284- E2290.
doi: 10.1002/hed.24185
29 Ga le , Poljak M , Zidar N . Update from the 4th edition of the world health organization classification of head and neck tumours: what is new in the 2017 WHO blue book for tumours of the hypopharynx, larynx, Trachea and parapharyngeal space[J]. Head Neck Pathol, 2017, 11 (1): 23- 32.
doi: 10.1007/s12105-017-0788-z
30 Karatayli-Ozgursoy S , Pacheco-Lopez P , Hillel AT , et al. Laryngeal dysplasia, demographics, and treatment: a single-institution, 20-year review[J]. JAMA Otolaryngol Head Neck Surg, 2015, 141 (4): 313- 318.
doi: 10.1001/jamaoto.2014.3736
[1] 石金莲,李建兴,黄幼生,林铭轩,刘灵云,卢永田. 喉部炎性肌纤维母细胞瘤的研究现状与诊疗进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 186-192.
[2] 周之航,刘素茹,周静,陈丹,杨佳静,刘蕊,周立. 声门闭合不全的病因及诊疗研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 97-103.
[3] 潘佳煜,张春林. 急性低频感音神经性听力下降病因及发病机制的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 126-131.
[4] 李志成,闫亚,戴梁平,应俊杰, 王仁忠. 嗅觉障碍小鼠和大鼠模型的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 158-167.
[5] 彭宇婷,李坚昊,王燕. 鼻-眼眶-颅底恶性肿瘤继发眶尖综合征1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 105-111.
[6] 涂巧铃,李玉凤,彭军. 鼻咽癌中抗PD-L1/PD-1治疗及非编码RNA调控研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 135-141.
[7] 唐慧新,李景景,邹红. 阈值下微脉冲激光光凝作用机制及临床应用[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 143-148.
[8] 王兴鑫,杨欣雨,郑晓军,丁麟,盛亚文,毕晓云,杨继国. 穴位贴敷疗法治疗小儿腺样体肥大1例[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 122-124.
[9] 张静祎,王文一,荣凌燕,张家奎,宋西成. 中药热奄包外敷联合七叶皂苷钠静滴治疗鼻部外伤肿胀疗效观察[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 21-26.
[10] 青晓艳,徐义全,李超. 甲状腺未分化癌的分子机制研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 26-31.
[11] 徐进敬,胡京华,吴元庆,邓毅,喻唯唯. CO2激光显微手术在喉癌前病变和早期声门型喉癌中的应用[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 129-133.
[12] 郝文培, 翟华蕾, 孙晓彤, 张雅妮, 朱艳辉, 孔倩倩, 程钧, 张婷. 角膜再移植原因与植片失活的危险因素分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 134-140.
[13] 伊海金,杨仕明. 重视耳部外伤诊疗工作[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 1-3.
[14] 梁程程,王欣,雷大鹏. 电子鼻咽喉镜诊治27400例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 107-110.
[15] 谢慧. 眩晕的中医认识[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 11-17.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!