头颈部小涎腺腺样囊性癌的临床病理及预后因素：130例临床分析
Clinicopathologic and prognostic factors in adenoid cystic carcinoma of head and neck minor salivary glands: A clinical analysis of 130 cases.
作者信息
He Shizhi, Li Pingdong, Zhong Qi, Hou Lizhen, Yu Zhenkun, Huang Zhigang, Chen Xuejun, Fang Jugao, Chen Xiaohong
机构信息
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Capital Medical University, No.1, Dongjiaominxiang Street, Dongcheng District, Beijing 100730, PR China.
Department of Otolaryngology-Head and Neck Surgery, Nanjing Tongren Hospital, Jiyin Road 2007, Nanjing, Jiangsu Province 211102, PR China.
出版信息
Am J Otolaryngol. 2017 Mar-Apr;38(2):157-162. doi: 10.1016/j.amjoto.2016.11.014. Epub 2016 Nov 23.
PURPOSE
This study was to investigate clinicopathologic characteristics and prognostic factors in adenoid cystic carcinoma of head and neck minor salivary glands.
MATERIALS AND METHODS
We conducted a retrospective review of 130 patients with adenoid cystic carcinoma of head and neck minor salivary glands that were evaluated between 2000 and 2013 in Beijng Tongren Hospital.
RESULTS
Five-year overall survival and disease-free survival rates were 80.8% and 55.6%. Local recurrence rate was 40%, regional recurrence 3.8%, and distant metastasis was 28.5%. On univariate analysis, solid histological subtype, perineural invasion, positive surgical margins and advanced stages were found to be poor prognostic indicators. On multivariate analysis, solid histological subtype and positive surgical margins were significant prognostic factors of worse overall survival.
CONCLUSIONS
Solid histological subtype and positive surgical margins were the most important predictors of poor outcome in adenoid cystic carcinoma of minor salivary glands. Surgery with postoperative radiation were recommended treatment and offered durable local control.
目的
本研究旨在探讨头颈部小涎腺腺样囊性癌的临床病理特征及预后因素。
材料与方法
我们对2000年至2013年在北京同仁医院接受评估的130名头颈部小涎腺腺样囊性癌患者进行了回顾性研究。
结果
5年总生存率和无病生存率分别为80.8%和55.6%。局部复发率为40%，区域复发率为3.8%，远处转移率为28.5%。单因素分析发现，实体组织学亚型、神经周围侵犯、手术切缘阳性和晚期是不良预后指标。多因素分析显示，实体组织学亚型和手术切缘阳性是总生存较差的显著预后因素。
结论
实体组织学亚型和手术切缘阳性是小涎腺腺样囊性癌预后不良的最重要预测因素。建议采用手术加术后放疗的治疗方法，以实现持久的局部控制。
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