Related Factors For Dysplasia In Recurrent Respiratory Papilloma In Adults

Objective: To exploreatypical hyperplasia and malignancy rates in adult-onset recurrent respiratory papillomatosis(AO-RRP)and toanalyze the related factors ofthese poor progression.Methods: Retrospectively collected AO-RRP patients from January 2009 to January 2017.They are divided into poor progression group and benign group.The poor progression group was defined as pathological diagnosis with dysplasia or malignancy.The benign group was pathologically diagnosed as benign papilloma only.The differences in 10 factors such as the age of onset,sex,the number of lesion subregions,smoking,alcohol consumption,course of disease,average number of operations,tracheotomy,absolute lymphocyte count(ALC),absolute monocyte count(AMC)were observed.The differences in 10 factors such as surgery,absolute mononuclear cell count(AMC),and absolute lymphocyte count(ALC)were used to determine the factors associated withpoor progression.Results:60AO-RRP patients were identified:28(47%)patients had poor progression,13(22%)patients had atypical hyperplasia,and 15(25%)had malignant transformation.The average age of onset in the AO-RRP poor progression group was significantly higher than that in the benign group(P=0.006<0.05),The difference between the average age of onset was approximately 10 years(51 vs 41 years old),and the number of lesions invaded subregions was greater(P<0.05).It may indicate that the older the age of onset,the more likely to have poor progression(p = 0.04,or = 1.05,95% CI is 1.00-1.10);the more lesions invaded subregions,the more prone to poor progression(p = 0.04,or = 1.60 The 95% CI was 1.02-2.53).Compared with the benign group,the poor progression group had more surgical intervention times and lower ALC levels(P<0.05),but the results ofmulti-factor analysis did not confirm that they were the factors of poor progression of AO-RRP(P>0.05).There was no difference in gender,course of disease,smoking,alcohol consumption,tracheotomy,and AMC levels between the two groups.Conclusions: In AO-RRP patients,the atypical hyperplasia rate was 22%,and the 25% malignancy rate was basically the same as that of domestic studies,but lower than that of a series of foreign studies.The age of onset and the number of lesion subregions are risk factors for poor progression,which may indicate that the older the age of onset,the more lesions invaded subregions,the more likely it is that poor progression occurs.