涎腺导管癌9例报道及文献复习

Salivary Duct Carcinoma:Report of 9 Cases and Review of the Literature

目的:探讨涎腺导管癌临床病理学特征、治疗方法及预后。方法:结合我院近十年收治的9例涎腺导管癌病例,回顾国内详细记载涎腺导管癌病例报告,对其发病特点、临床表现、组织病理学特征、治疗方法和预后情况进行分析。结果:涎腺导管癌好发于老年人,以腮腺导管癌多见,临床上表现为质硬、界限不清肿块,常伴有神经侵犯症状。主要病理学特征是导管样细胞巢呈实质性、筛孔状和乳头状结构,中心有粉刺样坏死。治疗以手术扩大切除加颈淋巴清扫术为主,辅以术后放疗或化疗。术后易复发,颈淋巴结转移率高,常发生远处转移。结论:涎腺导管癌是一类较少见,且恶性程度很高的涎腺恶性肿瘤,预后较差,癌基因C-erbβ2和p53检测可能对判断早期局部复发、远处转移和生存率有所帮助。

Objective： To explore the clinicopathologic characteristics,treatment and prognosis of salivary duct carcinoma. Methods： Nine cases of salivary duct carcinoma treated in our hospital were reported and the Chinese literatures of the cases were reviewed. The occurrence condition, clinical characteristics, histological features, therapy methods and prognosis condition were analyzed. Results： Salivary duct carcinoma predominantly influenced old male patients and mainly occured in the parotid gland. Physical examination revealed a firm and immobile and unboundary mass being accompanied by nerve infiltrated symptom. The histological appearance was characterized by solid cell nests with ductal structures and central comedonecrosis. Treatment required extentive resection and radical neck dissection with radiotherapy and chemotherapy postoperatively. The clinical course was marked by development of both local disease recurrence as well as cervical lymph code and distant disease metastasis. Conclusion： Salivary duct carcinoma is a rare malignant salivary tumour and prognosis is poor. Expression of C -erbβ2 和 p53 was linked to the early local disease recurrence ,distant disease metastasis and survival rates.