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腺样囊性癌的临床病理回顾及生存特征

Clinicopathological review and survival characteristics of adenoid cystic carcinoma.

作者信息

Binesh Fariba, Akhavan Ali, Masumi Omid, Mirvakili Abbas, Behniafard Nasim

机构信息

Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Radiotherapy, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(Suppl 1):62-6. doi: 10.1007/s12070-014-0755-x. Epub 2014 Aug 5.

Abstract

To study the clinical characters, the outcomes of treatments and the factors affecting treatment results of adenoid cystic carcinomas at Shahid Sadoughi Hospital and Shahid Ramazanzadeh radiotherapy center, Yazd, Iran. The clinical data of 31 patients with adenoid cystic carcinoma of any anatomic site diagnosed over an 8 year period (2004-2012), were investigated retrospectively. Data regarding patients' characteristics, pathological features and follow-up were obtained from patients records. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression. The study included31 patients with adenoid cystic carcinoma. The mean age at presentation was 50.2 ± 24.8 years. There were 11 (35.5 %) males and 20 (64.5 %) females with a female predilection (M:F = 0.55:1). Parotid gland was the most common site (8/31, 25.7 %) followed by submandibular gland (7/31, 22.6 %). Perineural invasion was detected in 67.7 % of the cases. Positive surgical status was reported in 48.4 % of the specimens. Metastasis was detected in 25.8 % of the patients and the most common site of distant metastasis was lung. Overall survival rates at 2, 5, and 7 years were 95, 75, and 57 % respectively. Margin status showed significant effect on survival (P value = 0.01). Positive surgical margin is an important factor affecting the prognosis of the patients with adenoid cystic carcinoma. Surgery with negative surgical margin is the first choice of treatment for the patients with adenoid cystic carcinoma. Our findings show that the prognosis of patients with adenoid cystic carcinoma in our center is fair.

摘要

为研究伊朗亚兹德市沙希德·萨杜基医院和沙希德·拉马赞扎德放射治疗中心腺样囊性癌的临床特征、治疗结果及影响治疗效果的因素,对8年期间(2004 - 2012年)确诊的31例任何解剖部位的腺样囊性癌患者的临床资料进行回顾性研究。从患者记录中获取有关患者特征、病理特征及随访的数据。采用Kaplan - Meier法分析生存率、局部复发率和远处转移率。通过Log - rank检验和Cox回归分析预后因素。该研究纳入31例腺样囊性癌患者。就诊时的平均年龄为50.2±24.8岁。男性11例(35.5%),女性20例(64.5%),女性居多(男∶女 = 0.55∶1)。腮腺是最常见的部位(8/31,25.7%),其次是下颌下腺(7/31,22.6%)。67.7%的病例检测到神经侵犯。48.4%的标本报告手术切缘阳性。25.8%的患者检测到转移,远处转移最常见的部位是肺。2年、5年和7年的总生存率分别为95%、75%和57%。切缘状态对生存有显著影响(P值 = 0.01)。手术切缘阳性是影响腺样囊性癌患者预后的重要因素。手术切缘阴性的手术是腺样囊性癌患者的首选治疗方法。我们的研究结果表明,我们中心腺样囊性癌患者的预后尚可。

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