Analysis Of Risk Factors And Treatment Of Rosai-dorfman's Nose Disease

Objective:Rosai-Dorfman disease(RDD)is a type of tissue-cell proliferative disease,which can affect any part of the body,but the cause is unclear and relatively rare,especially the nasal lesions.Because it is rare and easy to be misdiagnosed clinically,and clinicians lack understanding of the disease,the vast majority of patients cannot receive timely and effective treatment.Although the disease is a benign lesion,but some patients delay difficult to heal,affect the lives of patients,and even a certain degree of fatal.The case reports of this disease were collected,the nasal cases were screened out,the characteristics of the nasal lesions were revealed through systematic review,and the risk factors affecting the prognosis and treatment methods were explored,so as to provide useful data for otolaryngologists in the diagnosis and treatment of this disease,and facilitate their understanding and understanding of this disease.Methods:Case reports or case series analysis related to Rosai-Dorfman's disease before 2018(excluding 2018)were retrieved and screened from the data sources of cnki,wanfang knowledge base,wip database,PubMed,EMBASE,MEDLINE and Cochrane databases.Finally,gender,data sources(at home and abroad),course of disease,clinical manifestations,laboratory tests and examinations,diagnosis,treatment and follow-up were extracted and summarized from the selected literatures,and 1 patient encountered in our department was counted.Finally,SPSS 22.0statistical software was used to explore the risk factors and treatment methods affecting the prognosis of nasal RDD disease through x~2 test,t test and binary Logistic regression model.Results:More than 1300 cases of RDD patients were searched from the databases of cnki,wanfang knowledge base,wirp,PubMed,EMBASE,MEDLINE and Cochrane,and 132 cases were screened out one by one,including 68 cases with complete data.A total of 69 female patients were admitted to our department.There were 39 cases abroad,30 cases in China,38 cases of male patients and 31 cases of female patients.Male patients were slightly more than female patients,and the ratio of male to female was 1.23:1.The average duration of the disease was 50.34±69.45 months from January to 30 years.The age of onset ranged from 10 years to 86 years,with an average age of 40.72±17.87 years.There were 27 cases with lymph node enlargement,14 cases with increased serum immunoglobulin,16 cases with increased white blood cells,and 15 cases with anemia.There were 23 cases and 22 cases with bone destruction involving nasal and extra-nasal tissues or organs.There were 12 cases of non-surgical internal medicine,42 cases of simple surgery and 15 cases of surgery combined with internal medicine.Among the prognosis,44 caseswere cured,24cases had tumor persistence or recurrence and progression,and 1 case died.1.Univariate analysis of prognostic factors affecting nasal RDD:Elevated serum immunoglobulin significantly affected the prognosis of patients(P<0.05).Anemia significantly affected the prognosis of patients(P<0.05).Other factors had no significant effect on the prognosis of the patients2.Multivariate analysis of factors affecting the prognosis of patients with nasal RDD:the presence of elevated serum immunoglobulin was an independent risk factor affecting the prognosis of patients with nasal RDD(P=0.043,OR=0.082,95%CI:0.007-0.929).Anemia(P=0.125,OR=0.226,95%CI:0.034-1.509)has not been shown to be an independent risk factor.3.Univariate and multivariate analysis of treatment:the prognosis of surgical patients was significantly better than that of non-surgical patients,univariate analysis results(P<0.05)and multivariate analysis results(P=0.002,OR=32.549,95%CI:3.461-306.063).4.Univariate analysis of each factor:there was significant difference between the choice of surgical treatment for patients with multiple organ involvement(P<0.05).There was a significant relationship between lymph node enlargement and serum immunoglobulin elevation(P<0.05).Conclusion:1.Elevated serum immunoglobulin is an independent risk factor for nasal RDD;2.Gender,age,course of disease,data sources(at home and abroad),elevated white blood cells,anemia,bone invasion,multiple organ involvement and lymph node enlargement are not independent risk factors for patients with RDD of the nose,but anemia may affect the prognosis of patients;3.Surgery is an effective treatment,which can cure or alleviate the condition of most patients;Although hormone-based medical treatment has not proved to be an effective treatment,it can alleviate the condition of some patients.4.There is a certain correlation between lymph node enlargement and elevated serum immunoglobulin.