12例唾液腺嗜酸细胞癌临床病理分析

Primary oncocytic carcinoma of the salivary glands: a clinical and pathologic study of 12 cases

目的:观察唾液腺嗜酸细胞癌的临床和病理组织学特征,探讨其治疗与预后。方法 :回顾分析2001年3月—2010年9月诊治的12例唾液腺嗜酸细胞癌患者的临床和病理资料,并进行随访分析。应用SPSS 16.0软件包,采用Kaplan–Meier法进行生存分析,并绘制生存曲线。结果:唾液腺嗜酸细胞癌临床多表现为唾液腺无痛性、不规则肿块或颈淋巴结肿大。病理学上表现为嗜酸性肿瘤细胞,异形性明显,核仁显著和浸润性生长特征。手术是首选治疗,术后可结合放疗。本组患者随访6～120个月,7例无复发及转移,1例出现局部复发及远处转移后带瘤生存,2例死于局部复发,1例出现颈淋巴结转移后死于远处转移,1例放弃治疗死于肿瘤进展。随访中2年内复发3例,复发率25%;2年内死亡3例,死亡率25%。结论:唾液腺嗜酸细胞癌是一种罕见的头颈部恶性肿瘤,其病程短、进展快。治疗上首选根治性手术,肿瘤无法彻底切除、局部病变晚期或颈淋巴结转移者需行术后放疗。原发肿瘤分期和颈淋巴结转移是影响预后的主要因素。

PURPOSE：To investigate the clinicopathological feature of oncocytic carcinoma of the salivary gland,and discuss diagnosis,treatment and prognosis.METHODS：From March 2001 to September 2010,the clinical data and pathological features of 12 cases of oncocytic carcinoma of the salivary gland in Zhejiang Cancer Hospital were reviewed and analyzed retrospectively.All cases are followed up.The Kaplan-Meier method was used to calculate survival curves by SPSS 16.0 software package.RESULTS：The tumors were found mainly as a painless,irregular-shaped mass or lymphadenectasis in the head and neck firstly.Pathologically,oncocytic carcinoma of salivary gland origin was an extremely rare proliferation of malignant oncocytes with adenocarcinomatous architectural phenotypes,including prominent nucleoli and infiltrative qualities.Surgery was the principal treatment,and postoperative radiotherapy was used as adjuvant treatment.Of the 12 cases with follow-up for 6 to 120 months,7 cases survived without regional or distant metastases.1 case survived with regional and distant metastases.2 cases died of regional recurrences.1 case had lymphatic metastasis and died of distant metastasis finally.1 case had given up therapy and died of tumor progress ultimately.3 cases had local recurrence within 2 years,and the recurrence rate was 25%;3 cases died within 2 years,and the mortality rate was 25%. CONCLUSIONS：Oncocytic carcinoma of salivary gland origin is an extremely rare tumor in head and neck,with short course and rapid progress.Radical resection postoperative radiotherapy is the treatment of choice.The prognosis of oncocytic carcinoma may be associated with tumor stage,regional lymph node metastases and complete surgical excision.