83例涎腺恶性多形性腺瘤临床病理分析

Malignant pleomorphic adenoma of salivary glands:A clinicopathologic study of 83 cases

作者总结分析８３例恶性多形性腺瘤的临床病理特点。患者平均年龄５３岁，男女之比为１．２：１。肿瘤部位依次为腮腺４７．９％，颌下腺２４％、腭部２０％。肿瘤中恶性成份为癌型７６例，癌肉瘤型７例。明显影响预后的因素有（１）肿瘤部位；（２）组织学亚型，（３）肿瘤分化程度，（４）浸润状况，（５）淋巴结有无转移。患者５年生存率为５２．７％，恶性程度明显高于其它常见型涎腺癌。作者认为多形性腺瘤是它的癌前病变，早期切除多形性腺瘤能有效地防止其发生。

This paper presented the clinicopathologic features of 83 cases of malignant pleomorphic adenomas (MPA) of the salivary glands. The average age of the patients was53 vears old. The ratio from male to female was 1. 24 to 1. Thirty nine tumors located in parotid glands, twenty in submandibular glands and seventeen in palate. Histopathologically,the malignant component of 76 tumors was identified as carcinoma and 7 tumors as carcinosarcoma both in various types. The statistic analysis showed the factors which influenced the prognosis (P<0,05) included (1.) location, (2.) histologic subtype of malignant component, (3.) differentiation grade, (4.) infiltration status,and (5.) with or without lymph node metastasis in the initial operation. The prognosis of MPA was more ominous than that of/the conventional types of carcinoma, with only 52. 7% of 5 year survival rate. The authors concluded that the pleomorphic adenoma was the pre-cancerous lesion of MPA.Therefore,it is necessary to resect the pleomorphic adenoma as early as possible in order to prevent the occurence of the MPA