Taniuchi Masataka, Kawata Ryo, Terada Tetsuya, Higashino Masaaki, Nishimura Hiromi, Kurisu Yoshitaka, Kuwabara Hiroko, Hirose Yoshinobu
Department of Otorhinolaryngology - Head and Neck Surgery Osaka Medical and Pharmaceutical University Takatsuki Japan.
Department of Pathology Osaka Medical and Pharmaceutical University Takatsuki Japan.
Laryngoscope Investig Otolaryngol. 2022 May 21;7(3):766-773. doi: 10.1002/lio2.809. eCollection 2022 Jun.
Mucoepidermoid carcinoma (MEC) is the most common malignancy of the parotid gland, but the outcome depends on the histological grade. Therefore, the aim of this study was to evaluate MEC on the basis of histological grade.
Retrospective analysis.
We performed a retrospective analysis of data from patients whose initial treatment for MEC of the parotid gland was performed at our department between 1999 and 2021. We examined the association between the Armed Forces Institute of Pathology (AFIP) grade and outcome.
The AFIP grades were as follows: low, 26 cases; intermediate, 9 cases; and high, 31 cases. About 50% of cases were correctly diagnosed as malignant, and both grade and histology were accurately determined by fine-needle aspiration cytology in 20% of cases. The 5-year disease-free survival rate was 95.5% and 53.8% in the low-/intermediate- and high-grade cases, respectively. In the high-grade group, cases with recurrence were found to have a higher rate of lymph nodes metastasis than cases without recurrence. Furthermore, in this high-grade group, total sacrifice of the facial nerve did not reduce local recurrence. However, radical resection in the cases without tumor invasion to the nerve has decreased the local recurrence rate. The CRTC1-MAML2 fusion gene was expressed in 42.3% of low-/intermediate- and 14.3% of high-grade cases.
The survival rate in MEC was quite different between the low-/intermediate- and high-grade cases. However, the rate of correct assessment of the grade by fine-needle aspiration cytology was poor. In high-grade cases, total sacrifice of the facial nerve may improve the rate of local recurrence in cases without invasion of the main trunk of the nerve. Expression of the CRTC1-MAML2 fusion gene could be helpful in not only the assessment of grade but the prediction of recurrence.
黏液表皮样癌（MEC）是腮腺最常见的恶性肿瘤，但其预后取决于组织学分级。因此，本研究的目的是基于组织学分级评估MEC。
回顾性分析。
我们对1999年至2021年间在我科接受腮腺MEC初始治疗的患者数据进行了回顾性分析。我们研究了武装部队病理研究所（AFIP）分级与预后之间的关联。
AFIP分级如下：低级别，26例；中级，9例；高级别，31例。约50%的病例被正确诊断为恶性，20%的病例通过细针穿刺细胞学准确确定了分级和组织学。低级别/中级和高级别病例的5年无病生存率分别为95.5%和53.8%。在高级别组中，复发病例的淋巴结转移率高于未复发病例。此外，在该高级别组中，面神经全切并未降低局部复发率。然而，在肿瘤未侵犯神经的病例中进行根治性切除降低了局部复发率。CRTC1-MAML2融合基因在42.3%的低级别/中级病例和14.3%的高级别病例中表达。
低级别/中级和高级别MEC病例的生存率差异很大。然而，细针穿刺细胞学对分级的正确评估率较低。在高级别病例中，面神经全切可能会提高神经主干未受侵犯病例的局部复发率。CRTC1-MAML2融合基因的表达不仅有助于分级评估，还可用于预测复发。
4级。
