腮腺高分化黏液表皮样癌21例诊治分析

Retrospective analysis of 21 patients with low-grade mucoepidermoid carcinoma of the parotid gland

目的分析高分化黏液表皮样癌的适当治疗原则和方法与预后的相关性。方法对1991—2006年在我院治疗的21例高分化黏液表皮样癌患者的临床资料进行回顾分析,分析适当的治疗方法及影响预后的因素。结果 21例患者均经过手术治疗,5年生存率为90.5%,术后有5例复发,其中1例Ⅳ期患者术后远处转移死亡、1例Ⅱ期患者因术中肿瘤破裂黏液溢出导致术后复发而未再接受治疗于术后4.5年死亡、3例经再次手术治疗后痊愈。结论高分化黏液表皮样癌手术治疗后5年生存率较高,手术切缘癌细胞阳性是影响预后的重要因素;建议对肿瘤临床分期高、存在淋巴结转移、手术切除范围不足致切缘癌细胞阳性者术后放疗。

Objective To analyze the relationship between appropriate treatment principle and prognosis in Low-grade mucoepidermoid carcinoma（MEC）of the Parotid Gland.Methods Retrospective analysis of 21 patients underwent surgery from 1991 to 2006 at our hospital.Analyze the method of treatment and the prognostic factors.Results 5-year survival rate（OS）was 90.5%.5 cases recurrence,in which,1 patient of stage Ⅳ died from distant metastases after surgery,1 patient of stageⅡ due to tumor rupture and mucus overflow died in 4.5 years without treatment,3 patients cured after reoperation.Conclusion 5-year survival rate is high in Low-grade MEC,Surgical margin cancer cell existence is an important prognostic factor.It is suggested that radiotherapy should be adopted for the patients with high T stage,metastatic lymph node,cancer existence in surgical margin due to inadequate resection.