Barnes L, Rao U, Krause J, Contis L, Schwartz A, Scalamogna P
Department of Pathology, University of Pittsburgh Medical Center, Pa.
Oral Surg Oral Med Oral Pathol. 1994 Jul;78(1):64-73. doi: 10.1016/0030-4220(94)90119-8.
Salivary duct carcinoma is an uncommon and relatively unknown clinically aggressive adenocarcinoma of salivary origin that histologically demonstrates a remarkable resemblance to invasive carcinoma of the breast. We report the clinicopathologic features of 13 cases that were also examined by image analysis for DNA ploidy. The results were then analyzed collectively with the less than 100 cases of salivary duct carcinoma reported in the English-language literature to define the characteristics of this unusual neoplasm. The 12 men and one woman averaged 68 years of age (range, 49 to 90 years). All tumors arose in the parotid (10 cases) or submandibular glands (three cases). Nine tumors were aneuploid, three diploid, and one was indeterminate because of insufficient tissue. Follow-up (median, 24 months) was available in 12 cases: three patients died of disease, six were alive without disease, and three died of other causes. Combining our cases with those in the literature, a total of 104 cases, confirms that salivary duct carcinoma is a highly malignant neoplasm with distinctive clinical and pathologic features. It arises almost exclusively in the major salivary glands (96% of cases), is three times more common in men, and usually occurs in patients over 50 years of age (range, 22 to 91 years). One-third of patients experience local recurrences, 59% develop positive regional lymph nodes, 46% have systemic metastases (lungs and bones), and 65% die of their disease, usually within 4 years of diagnosis. Determination of tumor ploidy has no prognostic significance. The presence of distant metastasis was the only clinicopathologic feature that was statistically associated with prognosis (p = 0.02); all patients with systemic metastasis died of disease.
涎腺导管癌是一种罕见且临床侵袭性相对不明的涎腺源性腺癌，其组织学表现与乳腺浸润性癌极为相似。我们报告了13例涎腺导管癌的临床病理特征，并对其进行了DNA倍体的图像分析。然后将结果与英文文献中报道的不到100例涎腺导管癌病例进行汇总分析，以明确这种罕见肿瘤的特征。12名男性和1名女性，平均年龄68岁（范围49至90岁）。所有肿瘤均发生于腮腺（10例）或下颌下腺（3例）。9例肿瘤为非整倍体，3例为二倍体，1例因组织不足而无法确定。12例有随访资料（中位随访时间24个月）：3例患者死于本病，6例无病存活，3例死于其他原因。将我们的病例与文献中的病例相结合，共计104例，证实涎腺导管癌是一种具有独特临床和病理特征的高度恶性肿瘤。它几乎仅发生于大涎腺（96%的病例），男性发病率是女性的3倍，通常发生于50岁以上的患者（范围22至91岁）。三分之一的患者出现局部复发，59%出现区域淋巴结阳性，46%发生远处转移（肺和骨），65%的患者死于本病，通常在诊断后4年内。肿瘤倍体的测定无预后意义。远处转移的存在是唯一与预后有统计学关联的临床病理特征（p = 0.02）；所有发生远处转移的患者均死于本病。
