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头颈部腺泡细胞癌:基于 SEER 注册中心的一项人群研究。

Head & neck acinar cell carcinoma: a population-based study using the seer registry.

机构信息

Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.

Department of Preventive Medicine, School of Public Health, Shanghai Medical College, Fudan University, 138 Yi xue yuan Road, Shanghai, 200001, People's Republic of China.

出版信息

BMC Cancer. 2020 Jul 8;20(1):631. doi: 10.1186/s12885-020-07066-y.

Abstract

BACKGROUND

To explore the clinicopathologic characteristics, treatment and prognostic factors of head and neck acinar cell carcinoma (HNACC) comprehensively.

METHODS

A population-based study was conducted using data from the Surveillance, Epidemiology, and End Results database (1975-2016). Overall survival (OS) and HNACC-specific survival of patients with different clinicopathologic variables were compared using the Kaplan-Meier method and Cox multivariate regression.

RESULTS

A total of 2624 primary HNACC cases (1052 males, 1572 females) were identified. There was a significant difference in gender distribution. Among the total cohort, 2416 cases originated from salivary glands, including 2325 parotid gland ACC cases. Regardless of confounding factors, the 10-year and 20-year disease-specific survival (DSS) was 93.6 and 90%, respectively. Surgery was favourably associated with better DSS and OS [HR = 0.13, P = 0.0092 and HR = 0.23, P = 0.0203]. Gender was the only demographic independent prognostic factor for both DSS and OS [Male vs female, HR = 3.3, P = 0.0028 for DSS; HR = 2.44, P = 0.0376 for OS]. Higher pathological grade was adversely associated with DSS and OS [Grade II, HR = 4.03, P = 0.0444; Grade III + IV, HR = 35.64, P = 0.0000 for DSS; Grade III + IV, HR = 4.49, P = 0.0000 for OS, Grade I as reference]. In addition, TNM/AJCC stage was commonly associated with prognosis.

CONCLUSION

Surgery was the only favourable prognostic indicator for both DSS and OS. Gender, age, pathological differentiation and TNM/AJCC stage were independent prognostic factors for survival.

摘要

背景

全面探讨头颈部腺泡细胞癌(HNACC)的临床病理特征、治疗方法和预后因素。

方法

利用监测、流行病学和最终结果数据库(1975-2016 年)的数据进行了一项基于人群的研究。采用 Kaplan-Meier 方法和 Cox 多因素回归比较不同临床病理变量患者的总生存率(OS)和 HNACC 特异性生存率。

结果

共确定了 2624 例原发性 HNACC 病例(1052 例男性,1572 例女性),性别分布存在显著差异。在总队列中,2416 例起源于唾液腺,其中 2325 例为腮腺 ACC 病例。无论是否存在混杂因素,10 年和 20 年疾病特异性生存率(DSS)分别为 93.6%和 90%。手术与更好的 DSS 和 OS 显著相关[风险比(HR)=0.13,P=0.0092 和 HR=0.23,P=0.0203]。性别是 DSS 和 OS 的唯一独立预后因素[男性比女性,HR=3.3,P=0.0028 用于 DSS;HR=2.44,P=0.0376 用于 OS]。较高的病理分级与 DSS 和 OS 呈负相关[Ⅱ级,HR=4.03,P=0.0444;Ⅲ+Ⅳ级,HR=35.64,P=0.0000 用于 DSS;Ⅲ+Ⅳ级,HR=4.49,P=0.0000 用于 OS,Ⅰ级作为参考]。此外,TNM/AJCC 分期通常与预后相关。

结论

手术是 DSS 和 OS 的唯一有利预后指标。性别、年龄、病理分化和 TNM/AJCC 分期是生存的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ff/7346396/b56be77eb185/12885_2020_7066_Fig1_HTML.jpg

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