Deb Pratik Q, Suster David I
Department of Pathology, Immunology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.
Int J Surg Pathol. 2025 Feb;33(1):49-58. doi: 10.1177/10668969241256107. Epub 2024 Jun 5.
Primary pulmonary salivary gland-type carcinomas are rare malignancies arising from minor salivary gland tissue in the lower respiratory tract. Given their rarity, constituting <1% of all primary lung malignancies, their epidemiological features and outcomes remain poorly documented. This study analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database to identify primary pulmonary salivary gland carcinomas, including the most prevalent tumor types.
All patients diagnosed with mucoepidermoid carcinoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma, with the lung designated as the primary site between 1975 and 2019, were subject to analysis. Overall and disease-specific survival were calculated using Kaplan-Meier curves and Cox proportional hazards models.
The study identified 323 mucoepidermoid carcinoma, 284 adenoid cystic carcinoma, and 6 epithelial-myoepithelial carcinoma diagnosed as pulmonary salivary gland-type carcinoma. An analysis of age distribution revealed a unimodal pattern for both mucoepidermoid carcinoma and adenoid cystic carcinoma, with most patients diagnosed after age 40. Most patients were Caucasians (77% for mucoepidermoid carcinoma and 83% for adenoid cystic carcinoma). Both disease-specific and overall survival were worse for patients diagnosed at the age of 60 years or above. Race or sex did not significantly impact patient survival. High-grade mucoepidermoid carcinoma demonstrated a significantly worse prognosis than low or intermediate-grade mucoepidermoid carcinoma.
A comprehensive review of clinical and epidemiological features of pulmonary salivary gland-type carcinomas reveals that the age of diagnosis and tumor grade are the most significant factors in determining patient survival.
原发性肺涎腺型癌是起源于下呼吸道小涎腺组织的罕见恶性肿瘤。鉴于其罕见性，占所有原发性肺恶性肿瘤的比例不到1%，其流行病学特征和预后仍缺乏充分记录。本研究分析了美国国立癌症研究所监测、流行病学和最终结果（SEER）数据库中的数据，以确定原发性肺涎腺癌，包括最常见的肿瘤类型。
对1975年至2019年间诊断为黏液表皮样癌、腺样囊性癌和上皮-肌上皮癌且肺被指定为原发部位的所有患者进行分析。使用Kaplan-Meier曲线和Cox比例风险模型计算总生存率和疾病特异性生存率。
该研究确定了323例黏液表皮样癌、284例腺样囊性癌和6例上皮-肌上皮癌被诊断为肺涎腺型癌。年龄分布分析显示，黏液表皮样癌和腺样囊性癌均呈单峰模式，大多数患者在40岁以后被诊断。大多数患者为白种人（黏液表皮样癌患者中占77%，腺样囊性癌患者中占83%）。60岁及以上诊断的患者疾病特异性生存率和总生存率均较差。种族或性别对患者生存率无显著影响。高级别黏液表皮样癌的预后明显比低级别或中级别黏液表皮样癌差。
对肺涎腺型癌的临床和流行病学特征进行全面综述发现，诊断年龄和肿瘤分级是决定患者生存率的最重要因素。
