Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomotology, PR China.
Int J Oral Maxillofac Surg. 2012 Aug;41(8):952-7. doi: 10.1016/j.ijom.2012.04.023. Epub 2012 May 28.
Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm that originates most commonly in the major and minor salivary glands of the head and neck region. This study provides new information on head and neck ACC with cervical lymph node metastasis. Of 616 patients who underwent primary tumour resection from 1995 to 2008 in the authors' hospital, 62 cases with cervical lymph node metastasis were analyzed. The general incidence of cervical lymph node metastasis in ACC was approximately 10%. The base of tongue, mobile tongue and mouth floor were the most frequent sites of lymph nodes metastasis, with incidences of 19.2%, 17.6% and 15.3%, respectively. Most cases occurred via a classic 'tunnel-style' metastasis and the level Ib and II regions were the most frequently involved. Primary site and lymphovascular invasion were significantly associated with lymph node metastasis. High patient mortality was significantly correlated with lymph node positive cases. The tongue-mouth floor complex has a high propensity for cervical lymph node metastasis, which occurs through a classic 'tunnel-style' metastasis. Peritumoral lymphovascular invasion could be taken as strong predictor for lymph node metastasis, which ultimately leads to poor prognosis of ACC patient. Selective neck dissection should be considered in such cases.
腺样囊性癌（ACC）是一种罕见的恶性肿瘤，最常起源于头颈部的大、小唾液腺。本研究提供了头颈部伴有颈部淋巴结转移的 ACC 的新信息。作者医院 1995 年至 2008 年间对 616 例接受原发肿瘤切除术的患者进行了分析，其中 62 例有颈部淋巴结转移。ACC 颈部淋巴结转移的总发生率约为 10%。舌底、活动舌和口底是淋巴结转移最常见的部位，发生率分别为 19.2%、17.6%和 15.3%。大多数病例通过经典的“隧道样”转移发生，Ib 和 II 区最常受累。原发部位和淋巴管侵犯与淋巴结转移显著相关。高患者死亡率与淋巴结阳性病例显著相关。舌-口底复合体有较高的颈部淋巴结转移倾向，通过经典的“隧道样”转移发生。肿瘤周围淋巴管侵犯可作为淋巴结转移的强预测因子，最终导致 ACC 患者预后不良。在这种情况下应考虑选择性颈清扫术。
