二氧化碳激光治疗喉癌前病变及早期声门型喉癌的临床疗效及预后分析OACSTPCD

Objective:To explore the efficacy and prognosis analysis of CO2 laser in laryngeal precancerous lesions(LPL)and early glottic laryngeal cancer(EGLC).Methods:Clinical data of 61 cases of LPL(15 cases of laryngeal papil-loma and 46 cases of vocal cord leukoplakia)and 30 EGLC patients who underwent CO2 laser treatment with supporting la-ryngoscope in our otolaryngology department from January 2019 to December 2023 were continuously included,and postoper-ative follow-up was conducted.Kaplan-Meier method was used to calculate the overall survival(OS)and disease-free surviv-al(DFS)of LPL and EGLC patients treated by CO2 laser.Cox proportional hazards model was used to analyze the factors in-fluencing the recurrence rate of LPL and EGLC patients after CO2 laser treatment.Results:Among EGLC patients,there were 3 cases of local recurrence,with a local recurrence rate of 10.0％(3/30).The highest local recurrence rate occurred in T2 patients[50.0％(1/2)],but there was no statistically significant difference between different clinical stage groups(x2=3.059),P=0.217).The local recurrence rate of patients with laryngeal papilloma was 40.0％(6/15),and that of patients with vocal cord leukoplakia was 8.7％(4/46).There was a statistically significant difference in local recurrence rate between the two groups(x2=8.088,P=0.004).Multivariate Cox regression analysis showed that disease type was an independent risk factor for recurrence in LPL pa-tients after CO2 laser treatment.Patients with laryngeal papilloma had a higher risk of recurrence after surgery compared to those with vocal cord leukoplakia(RR=5.198,95％CI:1.089～33.228,P=0.044).Clinical stage is an independent risk factor for recurrence after CO2 laser treatment in EGLC patients.T2 patients have a higher risk of postoperative recur-rence compared to patients with cancer in situ(RR=1.758,95％CI:1.020～5.131,P=0.022).Conclusion:The OS and DFS of LPL or EGLC patients treated with CO2 laser are relatively high,and the clinical efficacy is significant.Laryngeal papilloma is an independent risk factor for postoperative recurrence in LPL patients,and clinical stage T2 is an independent risk factor for postoperative recurrence in EGLC patients.