Del Signore Anthony G, Megwalu Uchechukwu C
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Ear Nose Throat J. 2017 Mar;96(3):E13-E16. doi: 10.1177/014556131709600319.
We performed a population-based historical cohort study using the Surveillance, Epidemiology, and End Results (SEER) database to determine trends in the incidence of major salivary gland cancer and to evaluate the effect of sex, tumor size, histology, primary site, and extent of disease. Participants were men and women with major salivary gland cancer, diagnosed 1973-2009. The incidence of major salivary gland cancer increased from 10.4 per 1,000,000 in 1973 to 16 per 1,000,000 in 2009 (annual percent change [APC] 0.99; 95% confidence interval [CI] 0.78 to 1.20; p < 0.05). The incidence of parotid cancers increased (APC 1.13; 95% CI 0.88 to 1.39; p < 0.05) and paralleled the increase in major salivary gland cancer overall. There was an increase in the incidence of tumors measuring 0 to 2.0 cm (APC 1.99; 95% CI 0.61 to 3.38; p < 0.05), but no change in tumors measuring 2.1 to 4.0 cm (APC 1.02; 95% CI -0.46 to 2.52; p > 0.05) and tumors measuring > 4 cm (APC -0.52; 95% CI -1.72 to 0.69; p > 0.05). There was an increase in the incidence of regional (APC 0.77; 95% CI 0.32 to 1.23; p < 0.05) and distant (APC 2.43; 95% CI 1.43 to 3.45; p < 0.05) disease, but not localized disease (APC 0.35; 95% CI 0 to 0.71; p > 0.05). We conclude that the incidence of major salivary gland cancer is increasing, especially small parotid tumors. The incidence of tumors with regional and distant metastasis is also increasing. These findings highlight the need for further research on the etiology of salivary gland cancer, which may reveal opportunities for further public health efforts aimed at prevention.
我们利用监测、流行病学和最终结果（SEER）数据库开展了一项基于人群的历史性队列研究，以确定大唾液腺癌的发病率趋势，并评估性别、肿瘤大小、组织学类型、原发部位和疾病范围的影响。研究对象为1973年至2009年间诊断为大唾液腺癌的男性和女性。大唾液腺癌的发病率从1973年的每100万人中10.4例增至2009年的每100万人中16例（年百分比变化[APC]为0.99；95%置信区间[CI]为0.78至1.20；p<0.05）。腮腺癌的发病率有所上升（APC为1.13；95%CI为0.88至1.39；p<0.05），且与大唾液腺癌总体发病率的上升趋势一致。大小为0至2.0厘米的肿瘤发病率上升（APC为1.99；95%CI为0.61至3.38；p<0.05），但大小为2.1至4.0厘米的肿瘤发病率无变化（APC为1.02；95%CI为-0.46至2.52；p>0.05），大小大于4厘米的肿瘤发病率下降（APC为-0.52；95%CI为-1.72至0.69；p>0.05）。局部区域（APC为0.77；95%CI为0.32至1.23；p<0.05）和远处（APC为2.43；95%CI为1.43至3.45；p<0.05）疾病的发病率上升，但局限性疾病发病率未上升（APC为0.35；95%CI为0至0.71；p>0.05）。我们得出结论，大唾液腺癌的发病率正在上升，尤其是小的腮腺肿瘤。伴有局部区域和远处转移的肿瘤发病率也在上升。这些发现凸显了对唾液腺癌病因进行进一步研究的必要性，这可能会揭示开展更多旨在预防的公共卫生工作的机会。
