Wang X L, Zhou M J, Ma T Y, Jiang L Y, Zhao Q D, Xu H B, Zhou J, Li L F, Kong L, Chen Xiaohong
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China.
Department of Otolaryngology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Aug 7;57(8):963-968. doi: 10.3760/cma.j.cn115330-20220508-00256.
To analyze the prognosis and risk factors of lung metastasis of patients with adenoid cystic carcinoma(ACC) of head and neck. A retrospective study was conducted. The data of 157 patients with ACC of head and neck treated in Beijing Tongren Hospital, Capital Medical University from January 2014 to October 2020 were collected, including 72 males and 85 females, with onset age between 14 and 72 years old. According to whether lung metastasis occurred, the patients were divided into lung metastasis group (88 cases) and non-pulmonary metastasis group (69 cases). Kaplan-Meier method was used to calculate the overall survival rate and progression-free survival rate using SPSS 26.0 software. Log-rank test was used to evaluate statistically relevant clinicopathological factors. Cox proportional risk model was used in multivariate analysis for the factors affecting the lung metastasis-free survival using R Studio 1.2.5042. The 3-year and 5-year overall survival rates were 91.5% and 85.2%, respectively. The 3-year and 5-year progression-free survival rates were 57.7% and 34.3%, respectively. Univariate analysis showed that primary site, histological grade, high-grade transformation, Ki-67, T stage, and lymph node status were the risk factors for lung metastasis (χ=11.78, 10.41, 4.06, 4.71, 5.37, 16.20, respectively, all <0.05). Multivariate analysis showed independent risk factors for lung metastasis, including submandibular gland and sublingual gland (=3.53, 95%: 1.19-10.46, <0.05), T3-4 stage (=3.09, 95%: 1.54-6.23, <0.05), and Grade Ⅱ-Ⅲ grade (=2.47, 95%: 1.26-4.86,<0.05). Distant metastasis, mainly pulmonary metastasis, affects the long-term prognosis of patients with ACC significantly. Primary site, T stage and histopathological grade can be used as the predictors for the risk of lung metastasis.
分析头颈部腺样囊性癌（ACC）患者肺转移的预后及危险因素。进行一项回顾性研究。收集了2014年1月至2020年10月在首都医科大学附属北京同仁医院接受治疗的157例头颈部ACC患者的数据，其中男性72例，女性85例，发病年龄在14至72岁之间。根据是否发生肺转移，将患者分为肺转移组（88例）和非肺转移组（69例）。使用SPSS 26.0软件通过Kaplan-Meier法计算总生存率和无进展生存率。采用Log-rank检验评估具有统计学意义的临床病理因素。使用R Studio 1.2.5042通过Cox比例风险模型对影响无肺转移生存的因素进行多因素分析。3年和5年总生存率分别为91.5%和85.2%。3年和5年无进展生存率分别为57.7%和34.3%。单因素分析显示，原发部位、组织学分级、高级别转化、Ki-67、T分期和淋巴结状态是肺转移的危险因素（χ分别为11.78、10.41、4.06、4.71、5.37、16.20，均<0.05）。多因素分析显示肺转移的独立危险因素包括下颌下腺和舌下腺（=3.53，95%：1.19 - 10.46，<0.05）、T3 - 4期（=3.09，95%：1.54 - 6.23，<0.05）以及Ⅱ - Ⅲ级（=2.47，95%：1.26 - 4.86，<0.05）。远处转移，主要是肺转移，显著影响ACC患者的长期预后。原发部位、T分期和组织病理学分级可作为肺转移风险的预测指标。
