鳃裂癌治疗及预后的系统回顾分析

Treatment and prognosis of branchiogenic carcinoma:a systematic analysis

目的通过文献分析总结鳃裂癌的临床病理学特点,为鳃裂癌的治疗及预后判断提供依据。方法计算机检索Cochrane Library、Wiley Online Library及Pub Med网络数据库,查找英文文献中符合鳃裂癌1989年最新诊断标准的病例,提取临床病理资料,应用SPSS软件进行相关分析。结果 26篇文献共32例患者符合鳃裂癌最新诊断标准。其中男性27例(84.4%),女性5例(15.6%),平均年龄53岁。29例(90.6%)病理诊断为侵袭性癌,3例(9.4%)为原位癌。8例患者发生颈淋巴结转移,其转移率为25.0%。随访期间(1月-20年)3例患者出现远处转移(肝、肺或脑);3例患者出现局部复发;4例患者死亡,其中2例患者死于远处转移,1例患者死于败血症,另1例死于冠心病。总体5年生存率为93.0%。结论鳃裂癌诊断应遵循严格的最新标准。手术切除肿瘤同时建议同期行选择性颈淋巴结清扫术。尽管局部复发或远处转移偶有发生,但鳃裂癌总体预后较好。

Objective To provide an evidence for treatment and prognosis of branchiogenic carcinoma by reviewing available cases in English literature and summarizing the clinicopathological characteristics of the disease.Methods Based on Khafif＇s updated criteria（1989）,32 eligible cases in 26 reports were reviewed.Clinicopathological information was extracted and the subsequent analysis was performed by SPSS software.Results The 32 patients with branchiogenic carcinoma included 27 men（84.4%） and 5 women（15.6%） with the mean age of 53 years.Pathologically,29 patients（90.6%） were identified as invasive carcinoma and 3 patients（9.4%） as carcinoma in situ.The overall cervical lymph node metastasis rate was 25.0%（8/32）.Distant metastasis（liver,lung or brain） was detected in 3 patients.Four patients died during the follow-up period（one month to 20 years）,of whom,two patients died of distant metastasis,one patient died of lethal sepsis and one died of coronary disease.The 5-year survival rate was 93.0%.Conclusion Branchiogenic carcinoma should be diagnosed strictly following the updated diagnostic criteria.Apart from surgical excision of tumor,the elective neck dissection is recommended considering the high cervical metastasis rate.Although the local recurrence and distant metastasis are detected occasionally,branchiogenic carcinoma is not a poor-prognosis disease on the whole.