喉部病变的免疫组化分析及临床-喉镜相关性

C. Rimoli, R. Hamerschmidt, Júlia Rodrigues Marcondes Dutra, Evaldo Dacheux de Macedo Filho, H. Pauna
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摘要

声带易受几种类型病变的影响。免疫组织化学是一种旨在补充常规组织病理学调查的技术,通过特异性抗体显示组织或细胞中不同抗原的存在,从而可以评估肿瘤细胞的潜在增殖。目的:详细回顾声带活检结果及组织病理学资料与患者临床病程的关系。方法:一项描述性回顾性研究,基于对因良性疾病(息肉和结节)而接受喉部显微手术的患者的医疗记录分析,这些患者的活检需要使用免疫组织化学技术进行额外的调查。2018年1月至2019年12月,所有活检均由同一名专家在帕拉纳医院(Hospital Paranaense de otorrinaringologia)进行。结果:本研究纳入的29例患者中有7例(26例男性和3例女性)自称是吸烟者。18例高危HPV患者诊断免疫组化均为阴性。19例疑似喉部乳头状瘤病的患者,解剖病理检查3例为鳞状细胞癌。结论:由于不同类型声带病变的组织病理特征相似,组织病理检查的金标准存在较大的疑问。为了确定喉良性病变之间的差异,本文强调免疫组化检查在早期诊断和治疗明显良性病变中的重要作用。
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Immunohistochemical Analysis of Laryngeal Lesions and Clinical-Laryngoscopic Correlation
Introduction: The vocal fold is vulnerable to several types of lesions. Immunohistochemistry is a technique aimed to complement the routine histopathological investigation, showing the presence of different antigens in the tissue or cell by means of specific antibodies, thus allowing the assessment of the potential proliferation of neoplastic cells. Objective: Detailed review of the results of vocal fold biopsies and correlation between histopathological data and clinical course among patients. Methods: A descriptive retrospective study based on the analysis of medical records of patients undergoing laryngeal microsurgery due to benign diseases (polyps and nodules), whose biopsies required additional investigation using immunohistochemistry techniques. All biopsies were carried out by the same specialist, from January 2018 to December 2019 at the Hospital Paranaense de Otorrinolaringologia. Results: Seven out of the 29 patients included in this study (26 male and 3 female patients) claimed to be tobacco users. All the 18 patients investigated for high-risk HPV scored negative in diagnostic immunohistochemistry. Three of the 19 patients with suspected laryngeal papillomatosis resulted in squamous cell carcinoma in the anatomopathological examination. Conclusion: Due to similar histopathological aspects between the different types of vocal fold lesions, there is considerable doubt regarding the gold standard in histopathological examination. To determine the difference between benign lesions of the larynx, this paper reinforce the major role of performing immunohistochemistry examinations in the diagnosis of apparently benign lesions regarding early diagnosis and treatment.
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