腮腺常见良性肿瘤超声和临床特点研究

The study about ultrasonography and clinical characteristics in common parotid benign tumors

目的总结腮腺混合瘤、腺淋巴瘤、基底细胞腺瘤超声和临床特点,提高术前超声诊断准确性。方法回顾性分析2018年1月至2020年4月于首都医科大学附属北京友谊医院行腮腺肿瘤手术,最后病理诊断腮腺混合瘤、腺淋巴瘤、基底细胞腺瘤220例患者的病例资料,比较年龄、性别、吸烟史在3种腮腺常见良性肿瘤中差异;有首都医科大学附属北京友谊医院术前超声检查结果的患者119例,比较3种肿瘤病灶的单发/多发特性;共133个病灶,比较其左/右叶、回声、均质性、边界、形态、血流分布特点;多项Logistic回归分析年龄、性别、吸烟是否影响3种肿瘤患病情况。结果腮腺常见良性肿瘤中,腺淋巴瘤、混合瘤、基底细胞腺瘤患病率分别为57.0%、30.5%、11.2%。腺淋巴瘤在老年男性有吸烟史患者中发病率高。腮腺混合瘤平均发病年龄显著小于基底细胞腺瘤和腺淋巴瘤,腮腺混合瘤单发比率高于腺淋巴瘤、基底细胞腺瘤,肿瘤直径小于腺淋巴瘤、基底细胞腺瘤;腺淋巴瘤不均质、血流分级IV级比率高于腮腺混合瘤、基底细胞腺瘤。年龄、性别、吸烟史是3种常见腮腺良性肿瘤的独立危险因素。结论腮腺肿瘤患者可根据其年龄、性别、吸烟史、病灶单发/多发、血供情况,术前初步判定肿瘤可能为哪种病理类型,对临床诊治有一定指导意义。

Objective To improve the accuracy of preoperative ultrasound diagnosis in Pleomorphic adenomoa(PA),Adenolymphoma(AL)and Basal cell adenoma of the parotid gland(BCA).Methods A total of 220 patients who underwent parotid gland tumor surgery in Beijing Friendship Hospital,Capital Medical University,from January 2018 to April 2020 were retrospectively analyzed and were finally pathologically diagnosed with mixed parotid gland tumor,adenolymphoma,and basal cell adenoma.The differences in age,gender,and smoking history among the three common benign parotid gland tumors were compared.A total of 119 patients with preoperative ultrasound were examined in our hospital,and the single/multiple characteristics of the three tumor lesions were compared.The characteristics of left/right lobes,echo,homogeneity,boundary,morphology and blood flow distribution were compared.Multiple Logistic regression was used to analyze whether age,sex and smoking affected the incidence of the three kinds of tumors.Results Among the common benign tumors of parotid gland,the prevalence rates of adenolymphoma,mixed tumor and basal cell adenoma were 57.0%,30.5% and 11.2%,respectively.Adenolymphoma was more prevalent in older men with a history of smoking.The mean age of onset of mixed parotid adenoma was significantly lower than that of basal cell adenoma and adenolymphoma.The single incidence rate of parotid mixed tumor was higher than that of adenolymphoma and basal cell adenoma,and the tumor diameter was smaller than that of adenolymphoma and basal cell adenoma.Heterogeneity of adenolymphoma and grade IV ratio of blood flow grade were higher than mixed parotid adenoma and basal cell adenoma.Age,sex and smoking history were independent risk factors for three common benign parotid tumors.Conclusion Patients with parotid gland tumor can preoperatively determine the possible pathological type of tumor according to their age,gender,smoking history,single/multiple lesions and blood supply,which has certain guiding significance for clinical diagnosis and treatment.