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分泌性癌:加拿大东部的经验和文献回顾。

Secretory carcinoma: the eastern Canadian experience and literature review.

机构信息

Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, Dalhousie University, 5820 University Ave. 3rd Floor Dickson Bldg, Halifax, NS, B3H 2Y9, Canada.

Department of Pathology, Dalhousie University, Halifax, NS, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2018 Nov 16;47(1):69. doi: 10.1186/s40463-018-0315-6.

Abstract

BACKGROUND

Secretory Carcinoma (SC) is a recently described malignancy affecting salivary glands of the head and neck, with a paucity of evidence regarding the natural history, morbidity, and mortality. This study aimed to investigate the current treatment options utilized for SC, as well as its presentation and outcomes.

METHODS

This study is a retrospective case series and includes patients diagnosed with SC at four Maritime Canadian institutions. Literature review of patient outcomes following treatment of SC is also included.

RESULTS

Thirteen patients were identified. Parotid was the most common subsite (69%), followed by minor salivary gland (23%) and submandibular gland (8%). All patients were S100 positive and had at least one additional positive confirmatory stain, including mammaglobin, CK7, or vimentin. Two patients had N2b disease. All patients were treated with primary surgery, and four were offered adjuvant radiotherapy. There was one instance of locoregional recurrence, and one of metastasis. Three patients displayed perineural invasion on pathology, and one patient displayed lymphovascular invasion.

CONCLUSION

Secretory Carcinoma remains understudied regarding its natural history, presentation, and treatment options. This study is the largest single case series in Canada, and highlights the young age and possible aggressiveness of SC. As well, we provide the most comprehensive literature review to date, with a focus on treatment and outcomes for this disease entity.

摘要

背景

分泌性癌(SC)是一种新近描述的头颈部唾液腺恶性肿瘤,关于其自然史、发病率和死亡率的证据很少。本研究旨在探讨目前用于 SC 的治疗选择,以及其表现和结果。

方法

本研究是一项回顾性病例系列研究,包括在四个加拿大海洋机构诊断为 SC 的患者。还包括对 SC 治疗后患者结局的文献复习。

结果

共确定了 13 名患者。腮腺是最常见的部位(69%),其次是小唾液腺(23%)和下颌下腺(8%)。所有患者 S100 阳性,并且至少有一项额外的阳性确认染色,包括乳球蛋白、CK7 或波形蛋白。2 名患者有 N2b 疾病。所有患者均接受了原发性手术治疗,4 名患者接受了辅助放疗。有 1 例局部区域复发,1 例转移。3 名患者的病理显示有神经周围侵犯,1 名患者显示有血管侵犯。

结论

关于 SC 的自然史、表现和治疗选择,仍需要进一步研究。本研究是加拿大最大的单一病例系列研究,强调了 SC 的年轻年龄和可能的侵袭性。此外,我们提供了迄今为止最全面的文献综述,重点关注该疾病实体的治疗和结局。

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