组织学分级作为黏液表皮样癌的预后指标：2400 例患者的人群水平分析。
Histologic grade as prognostic indicator for mucoepidermoid carcinoma: a population-level analysis of 2400 patients.
机构信息
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
出版信息
Head Neck. 2014 Feb;36(2):158-63. doi: 10.1002/hed.23256. Epub 2013 Jun 14.
BACKGROUND
Mucoepidermoid carcinoma (MEC) is an uncommon malignancy. To the best of our knowledge, this is the largest study investigating disease-specific survival (DSS) of parotid MEC and the first population-level study of the distribution of nodal metastases.
METHODS
Patients with MEC of the parotid gland were identified in the Surveillance, Epidemiology, and End Results (SEER) database (1988-2009).
RESULTS
We identified 2400 patients with MEC: 522 low grade, 1137 intermediate grade, and 741 high grade. Five-year DSS rates for low-grade, intermediate-grade, and high-grade MEC were 98.8%, 97.4%, and 67.0%, respectively (p < .001). Negative prognostic factors included high grade, increasing patient age, and tumor size, extraparenchymal extension, nodal metastases, and distant metastases. High-grade MEC was more likely to have lymph node metastases in levels I to III (34.0%) than low-grade (3.3%) and intermediate-grade MEC (8.1%; p < .001).
CONCLUSION
Grade influences the prognosis and distribution of nodal metastases. Results indicate that management guidelines should vary based on grade.
背景
黏液表皮样癌（MEC）是一种罕见的恶性肿瘤。据我们所知，这是最大规模的研究调查腮腺 MEC 的疾病特异性生存（DSS），也是首次对淋巴结转移分布进行的人群水平研究。
方法
在监测、流行病学和最终结果（SEER）数据库（1988-2009 年）中确定腮腺 MEC 患者。
结果
我们确定了 2400 名 MEC 患者：低级别 522 例，中级别 1137 例，高级别 741 例。低级别、中级别和高级别 MEC 的 5 年 DSS 率分别为 98.8%、97.4%和 67.0%（p<.001）。负性预后因素包括高级别、患者年龄增加以及肿瘤大小、包膜外延伸、淋巴结转移和远处转移。高级别 MEC 在 I 至 III 区淋巴结转移的可能性高于低级别（3.3%）和中级别（8.1%；p<.001）。
结论
分级影响预后和淋巴结转移的分布。结果表明，管理指南应根据分级而有所不同。
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