涎腺腺样囊性癌的临床特征及预后分析

Clinical Characteristics and Prognosis Analysis of Salivary Gland Adenoid Cystic Carcinoma

目的分析涎腺腺样囊性癌(salivary adenoid cystic carcinoma,SACC)患者的临床特征,探究其与预后的相关性。方法回顾性分析收集2016年1月~2021年1月就诊于笔者医院口腔科腺样囊性癌患者的病例资料38例,采用统计学方法分析研究其临床特征和预后。结果SACC好发生于腭部、口底等部位,平均年龄为56.7岁,易转移至肺部、骨组织及肝脏等部位,其中T_(3)和T_(4)分期的患者有17例(44.7%),22例(57.9%)有神经侵袭(perineural invasion,PNI),17例(44.7%)侵犯淋巴结,术后复发13例(34.2%),PNI与术后复发有一定的相关性(P<0.05),淋巴结侵犯与生存率无相关性(P>0.05),手术切缘阳性和术后复发对预后生存率相关(P<0.05),5年生存率为73.7%。结论SACC是一种常见的涎腺恶性肿瘤,SACC手术切缘阳性、术后复发与预后生存率差异有统计学意义,淋巴结侵犯与预后生存率无显著相关性。

Objective To analyze the clinical characteristics of patients with salivary adenoid cystic carcinoma(SACC)and explore their relationships with prognosis.Methods The clinical data of 38 patients with adenoid cystic carcinoma who were treated in the oral and maxillofacial surgery department of our hospital from January 2016 to January 2021 were retrospectively analyzed.The clinical characteristics and prognosis were analyzed and studied by statistical methods.Results SACC usually occurred in the palate,and floor of the mouth.The average age was 56.7 years old.SACC was likely to metastasize to the lung,bone tissue and liver.Among them,there were 17 patients(44.7%)in T_(3) and T_(4) stages,22 patients(57.9%)had perineural invasion(PNI),17 patients(44.7%)had lymph node invasion,and 13 patients(34.2%)had postoperative recurrence.There was a correlation between postoperative recurrence and survival rate(P<0.05),while lymph node invasion was not correlated with survival rate(P>0.05).Positive surgical margin and postoperative recurrence were related to prognosis survival rate(P<0.05),and the 5-year survival rate was 73.7%.Conclusion SACC is a common salivary gland malignancy.The clinical T stage,positive resection margin,PNI and postoperative recurrence are correlated with prognostic survival rate of SACC.There is no significant correlation between lymph node invasion and prognostic survival rate.