Liu S, Ow A, Ruan M, Yang W, Zhang C, Wang L, Zhang C
Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Discipline of Oral and Maxillofacial Surgery, Alexandra Hospital, Jurong Health System, Singapore.
Int J Oral Maxillofac Surg. 2014 Jun;43(6):667-73. doi: 10.1016/j.ijom.2014.01.008. Epub 2014 Feb 23.
Mucoepidermoid carcinoma (MEC) is an infrequent malignant neoplasm that originates most commonly in the salivary glands. The present study aimed to provide new information on prognostic factors in patients with salivary gland MEC. A retrospective analysis of the medical records of patients diagnosed with primary salivary gland MEC between 2003 and 2010 was conducted. The incidence of MEC in the minor salivary glands (62.2%) was almost twice that in the major salivary glands (37.8%). The most frequently affected sites were the parotid gland and palate. Lymph node metastasis was reported more frequently in male than female patients (P = 0.02), in high-grade than low/intermediate grade lesions (P < 0.001), and in lesions involving the submandibular gland (P < 0.001). The disease-free survival (DFS) at 5 years was 80.47%, with rates of 98.0%, 86.5%, and 38.5% for low-, intermediate-, and high-grade tumours, respectively. Among various clinicopathological factors, the only independent prognostic factor was histological grade (P < 0.001). Primary tumour site and histological grade are two important factors affecting cervical lymph node metastasis. Histological grade is the only independent factor affecting survival beyond tumor lymph node metastasis (TNM) staging in salivary gland MEC. Further advances in therapy are needed to improve the outcomes for patients with high-grade lesions.
黏液表皮样癌(MEC)是一种罕见的恶性肿瘤,最常见于涎腺。本研究旨在提供有关涎腺MEC患者预后因素的新信息。对2003年至2010年间诊断为原发性涎腺MEC的患者病历进行了回顾性分析。小涎腺中MEC的发生率(62.2%)几乎是大涎腺(37.8%)的两倍。最常受累的部位是腮腺和腭部。男性患者的淋巴结转移报告频率高于女性患者(P = 0.02),高级别病变高于低/中级别病变(P < 0.001),以及累及下颌下腺的病变(P < 0.001)。5年无病生存率(DFS)为80.47%,低级别、中级别和高级别肿瘤的生存率分别为98.0%、86.5%和38.5%。在各种临床病理因素中,唯一的独立预后因素是组织学分级(P < 0.001)。原发肿瘤部位和组织学分级是影响颈部淋巴结转移的两个重要因素。组织学分级是影响涎腺MEC患者肿瘤淋巴结转移(TNM)分期后生存的唯一独立因素。需要进一步改进治疗方法以改善高级别病变患者的预后。