唾液腺黏液表皮样癌的预后及影响因素分析

Analysis of prognosis and influencing factors of mucoepidermoid carcinoma of salivary gland

目的分析唾液腺黏液表皮样癌患者术后预后情况,并探讨影响其预后的主要临床和病理因素。方法回顾性收集2001年1月—2016年2月在我院行手术治疗的78例唾液腺黏液表皮样癌患者的临床和病理资料,采用Kaplan-Meier法估算术后3、5、10年的生存率,采用Log-rank对数秩检验比较组间生存率差异,采用Cox比例风险回归模型进行多因素分析。结果1预后情况:78例唾液腺黏液表皮样癌患者术后3、5、10年的总体生存率依次为98.6%、89.6%和73.5%。2单因素分析结果:高分化组、无淋巴结转移组患者术后生存率明显高于中低分化组(Log-rank=10.03,P<0.01)、淋巴结转移组患者的值(Log-rank=8.57,P=0.01),且差异有统计学意义。3多因素分析结果:分化程度(HR=12.71;P=0.02)和淋巴结转移(HR=6.84;P=0.01)是影响唾液腺黏液表皮样癌患者术后预后的独立危险因素。结论分化程度、淋巴结转移是影响唾液腺黏液表皮样癌患者术后预后的重要临床、病理因素。对于低分化、淋巴结转移患者应采取综合治疗手段以提高术后预后。

Objects To analyze the prognosis of mueoepidennoid carcinoma （MEC） of salivary gland and to explore the elinieopahto- logical influencing factors. Methods 78 patients with MEC of salivary gland treated with operation in our hospital from January 2001 to February 2016 were retrospectively selected. Related clinieopahtologieal materials were collected. Postoperative survival rates of 3, 5 and 10 years were calculated by Kaplan-Meier method and prognostic factors were analyzed by Log rank tests and Cox regression model. Results （1）. The overall survival rates of 3, 5, and 10 years were 98.6%, 89.6% and 73.5% among patients with salivary gland MEC respectively after surgical therapy. （2）. Univariate analysis： The overall survival rates of patients with high differentiation and no lymphatic metastasis were statistically significantly higher than those of patients with low differentiation （ Log-rank = 10.03, P〈0.01 ） and lymphatic metastasis （ Log-rank = 8.57, P = 0.01 ） respectively. （ 3 ）. Multivariate analysis ： Pathologieal differentiation （ HR = 12.71 ; P = 0.02） and lymphatic metastasis （HR= 6.84; P = 0.01 ） were the independent elinieopahtologieal influencing factors among patients with salivary gland MEC after operation. Conclusion Pathological differentiation and lymphatic metastasis are the independent prog- nostic elinieopathologieal factors of salivary gland MEC. Comprehensive measures should be taken for patients with poorly differentiation or lymphatic metastasis to improve the postoperative prognosis.