口腔小涎腺腺样囊性癌47例局部复发及转移的临床分析

CLINICAL ANLYSIS OF REGIONAL RECURRENCE AND DISTANT METASTASIS OF 47 PATIENTS WITH MSACC

目的 小涎腺腺样囊性癌的发生率相对较高 ,由于其易发生局部复发和远处转移 ,因此对本病的治疗效果及预后有必要进行一些分析和探讨。方法 通过对 47例小涎腺腺样囊性癌的原发部位、组织分型、治疗方法和疗效等进行分析和统计学的多因素回归分析 ,了解和此病相关的各种因素与预后之间的关系。结果 腭部病灶的局部复发和远处转移率为 5 2 % ,2 9% ;舌部的的局部复发和远处转移率为 6 3% ,38% ;筛状型的局部复发和远处转移率为 33% ,2 5 % ;实体型的局部复发和远处转移率为 80 % ,6 0 % ;早期肿瘤的局部复发和远处转移率为 2 0 % ,2 0 % ;晚期肿瘤的局部复发和远处转移率为 80 % ,5 0 % ;综合治疗的局部复发和远处转移率为 36 % ,18% ;单纯手术治疗的局部复发和远处转移率为 71% ,5 7%。多因素回归分析结果 :肿瘤的临床分期和治疗方法的选择与局部复发和远处转移有明显的相关性。结论 该肿瘤的临床分期 ,手术切除的彻底性及综合治疗的应用是直接影响小涎腺腺样囊性癌的预后重要因素。

Objective The most frequent site of minor salivary adenoid cyctic carcinoma(MSACC)is the oral cavity,this carcinoma is characterized by its infiltrative growth and propensity for perineural invasion,the regional recurrence and distant metastasis are common.The purpose of this study is to analyse prognostic factors for influencing this disease. Methods This report showed the dignosis and treatment of 47 cases by pathological dignosis, including in the prognostic factors analysis, information concerning site, histological type, clinical stage and nature of therapy were compiled for each case.Results Regional recurrence and distant metastasis were present in 52% and 29% of patients with MSACC of the palate,63% and 38% with MSACC of tongue,33% and 25% with MSACC of cribriform pattern,80% and 60% with MSACC of solid pattern,36% and 18% patients with surgery plus chemotherapy,71% and 57% with simple surgery.Multivariate analysis showed that clinical stages and treatment had significant relation with the regional recurrence and distant metastasis of the patient with MSACC.Conclusion There are many factors influencing the regional recurrence and distant metastasis of MSACC,our finding showed that clinical stage,radical surgery and combined therapy are the important factors influencing the prognosis,which provide the patient with the best chance for long term survival.