涎腺多形性腺瘤260例临床病理分析

POLYMORPHIC ADENOMA OF THE SALIVARY GLAND: A CLINICOPATHOLOGIC STUDY OF 260 CASES

①目的 探讨涎腺多形性腺瘤的临床病理改变及其发病与恶变的关系。②方法 对 2 6 0例经病理诊断为涎腺多形性腺瘤及其恶变病人进行回顾性分析 ,按WHO(1991)涎腺肿瘤组织学分类法进行诊断分类 ,观察其发病年龄、发病部位、恶变及复发情况。③结果 2 6 0例病人中发生于腮腺 177例 ,颌下腺 36例 ,舌下腺 1例 ,小涎腺 46例 ;2 6 0例中 38例发生恶变 ,其中发生于大涎腺者中恶变 2 5例 ,发生于小涎腺者中恶变 13例。发生于小涎腺者恶变率高于大涎腺者 ,差异有显著性 (χ2 =8.15 ,P <0 .0 1)。 38例恶变者中包括腺癌 3例、腺样囊性癌 1例、鳞状细胞癌 1例及肌上皮癌 33例。④结论 涎腺多形性腺瘤多发生于腮腺 ,发生于小涎腺者恶变率高 ;多次复发可致恶变 ,首次手术完整切除病变是提高疗效的关键。

Objective\ To study the clinicopathologic features of polymorphic adenoma of salivary gland as well as the relationship of its occurrence and malignant change. \ Methods\ 260 cases of polymorphic adenoma confirmed pathologically were studied retrospectively. The diagnostic classification was done according to histological classification for tumours of salivary gland by WHO(1991).The patients age, tumour location, malignant change and recurrence were observed.\ Results\ The tumour locations were as follows: parotid gland(177), submandibular gland(36), sublingual gland(1), minor salivary gland(46). 38 cases were found to have malignant change in all 260 cases. Of the malignant change cases, 25 in major salivary gland and 13 in minor gland. The rate of malignant change was higher for those originated from minor gland than that originated from the one. The difference was significant( χ 2=8.15, P <0.01)\ Conclusion\ Polymorphic adenoma of salivary gland was commonly seen in parotid gland. The malignant change was common for those originated from minor gland. Multiple recurrences may cause malignant process. The key point to improve the outcome is to remove the tumour completely at the first operation.