Institute of Pathology, Academic Hospital, Braunschweig, Germany.
Professional Trade Association for Wood and Metal, Munich, Germany.
Eur Arch Otorhinolaryngol. 2016 Mar;273(3):649-54. doi: 10.1007/s00405-015-3596-7. Epub 2015 Mar 10.
The relative frequency of regional lymphogenic versus distant hematogenic metastases was evaluated in 369 patients with sinonasal adenocarcinoma of the intestinal type (ITAC). We assessed the results of neck dissections for a limited number of patients undergoing this surgical intervention. 117 ITAC patients were followed up for at least 5 years. Neck dissections were performed in 18 cases (15 primary and 3 secondary operations), 4 of which revealed carcinoma-positive lymph nodes. Metastases in lymph nodes were also diagnosed clinically in three other patients adding up to a total of seven individuals (6 % of 117) with lymphogenic metastases. In comparison, distant hematogenic metastases were identified in 15.4 % of these 117 patients. In the second group of 252 patients, the occurrence of distant hematogenic metastases and colorectal adenocarcinomas was registered but no formal follow-up procedure was applied. 50 neck dissections were performed in this group, 46 of which exhibited no histological evidence for metastases in lymph nodes, while in 1 case they were carcinoma-positive. Three additional cases showed clinical signs of metastases in regional lymph nodes. Taken together, our observations indicate that regional lymphogenic metastases are rather rare (about 2 %) in patients with sinonasal adenocarcinoma of the intestinal type. Therefore, the surgery of neck dissection appears not advised as routine intervention in these cases. ITAC patients show a normal prevalence of colorectal adenocarcinomas.
我们评估了 369 例具有肠型（ITAC）特征的鼻腔鼻窦腺癌患者的区域性淋巴转移与远处血行转移的相对频率。我们评估了进行这种手术干预的少数患者的颈部解剖结果。117 例 ITAC 患者的随访时间至少为 5 年。18 例患者（15 例原发性和 3 例继发性）进行了颈部解剖，其中 4 例显示淋巴结癌阳性。另外还有 3 例患者的颈部淋巴结临床诊断为转移，总计有 7 例（117 例患者的 6%）患者存在淋巴转移。相比之下，在这些 117 例患者中，有 15.4%的患者发生了远处血行转移。在第二组 252 例患者中，我们记录了远处血行转移和结直肠腺癌的发生情况，但没有进行正式的随访。该组中进行了 50 例颈部解剖，其中 46 例未发现淋巴结转移的组织学证据，而 1 例为癌阳性。另外 3 例显示区域性淋巴结转移的临床迹象。综上所述，我们的观察结果表明，具有肠型鼻腔鼻窦腺癌的患者中，区域性淋巴转移相当罕见（约 2%）。因此，在这些病例中，颈部解剖术似乎不建议作为常规干预。ITAC 患者的结直肠腺癌发病率正常。
