Choi Sung Yong, Choi Jaehyuck, Hwang Inwoo, Cho Junhun, Ko Young-Hyeh, Jeong Han-Sin
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Daejeon 34824, Korea.
J Clin Med. 2022 Mar 25;11(7):1808. doi: 10.3390/jcm11071808.
Background: Recurrence in pleomorphic adenoma (PA) has been debated as a risk factor for malignant transformation (MT). In this study, we investigated whether recurrence is a risk factor for MT, by longitudinally analyzing cases with recurrent PA (RPA), and carcinomas from PA (CXPA) or RPA (CXRPA). Methods: The study population included 24 CXPA, 24 RPA, 6 CXRPA, and 386 PA cases (study period 2010−2018). Time and event data were collected from the medical documents to identify the time−event sequences. Results: The time interval to MT in CXRPA was significant longer than that of benign recurrence (median 342.0 vs. 109.5 months). In CXRPA, the recurrence intervals were not shorter than those in RPA according to recurrence frequency. Crudely, the MT rate was 5.9% among primary cases and 20.0% among recurrent cases. However, the time-adjusted MT rates increased up to 11.4% (incubation time > 60 months) and 20.0% (>120 months) in primary cases, which were not different from recurrent cases. Conclusion: In these longitudinal analyses, we did not find any clinical evidence that recurrence facilitates MT in the background of PA. Instead, a long incubation time seems to be a key factor for MT of underlying RPA.
多形性腺瘤（PA）的复发一直被认为是恶性转化（MT）的一个危险因素。在本研究中，我们通过纵向分析复发性PA（RPA）、PA来源的癌（CXPA）或RPA来源的癌（CXRPA）病例，研究复发是否为MT的危险因素。方法：研究人群包括24例CXPA、24例RPA、6例CXRPA和386例PA病例（研究时间段为2010 - 2018年）。从医疗文档中收集时间和事件数据，以确定时间 - 事件序列。结果：CXRPA发生MT的时间间隔显著长于良性复发（中位数分别为342.0个月和109.5个月）。在CXRPA中，根据复发频率，复发间隔并不短于RPA中的复发间隔。粗略计算，原发病例的MT率为5.9%，复发病例为20.0%。然而，经时间调整后的原发病例MT率在潜伏期>60个月时升至11.4%，>120个月时升至20.0%，与复发病例无差异。结论：在这些纵向分析中，我们未发现任何临床证据表明在PA背景下复发会促进MT。相反，较长的潜伏期似乎是潜在RPA发生MT的关键因素。
