粘液表皮样癌128例疗效观察

Treatment outcome of mucoepidermoid carcinoma in 128 cases

目的 :分析探讨粘液表皮样癌 (MEC)的治疗方法。方法 :采集我院近 15年来有病理诊断的 MEC病例12 8例进行随访 ,根据 WHO(1991)涎腺肿瘤 TNM分期和临床分期标准进行重新分类 ,分析治疗方法与预后的关系。结果 :99例单纯手术治疗 (其中 2 7例联合根治术 ) ,2 6例加术后放疗 ,3例姑息治疗。随访到的 76例中按生存率法统计 5年存活率为 90 .7%。肿瘤复发与手术切缘及临床分期明显相关 ,5年内死亡的 5例均为临床 IV期的低分化型。结论 :对高分化 MEC进行局部扩大切除手术、对低分化的或临床 IV期的 ,特别是上颌的 MEC进行术后放疗均可以提高 5年存活率。鉴于 MEC存活 13年后仍有复发的病例 。

s〕Objectives: To study the treatment outcome of mucoepidermoid carcinoma(MEC).Methods:128 cases of MEC with definite pathologic diagnosis treated in our hospital during the past 15 years were investigated. The relationship between the effects of the therapy and the prognosis was analysed.Result:Treatment with surgical operation only was used in 99 cases,radiotherapy after operation was applied in 26 cases and follow up was carried out in 76 cases. 5 year survival rate was 90.7%.5 patients who died within 5 years after operation were all with the diagnosis of MEC in clinical stage Ⅳand poor differentiaton.Conclusion:The local extensive excision for the well differentiated MEC,the radiotherapy after operation for poorly differentiated or that of clinical stage Ⅳ,especially in maxilla,may increase 5 year survival rate.Since there were cases of recurrences of MEC 13 years after surgical treatment,long term follow up is necessary.