外耳及中耳恶性肿瘤的诊疗分析

Diagnosis and treatment of malignant tumors of external ear and middle ear

目的探讨外耳及中耳恶性肿瘤的临床类型、分期、治疗及预后。方法回顾性分析2008年1月-2020年3月在我院接受手术的23例外耳及中耳恶性肿瘤患者的临床资料。其病理类型分为鳞状细胞癌14例,腺样囊性癌8例,Merkel细胞癌1例,临床分期T1期2例,T2期7例,T3期10例,T4期4例。5例单独行手术治疗,13例行手术治疗及术后放疗,4例行手术治疗及术后放化疗,1例行放化疗。结果全组病人3年生存率69.6%,5年生存率52.2%,I、II期病人3年、5年生存率均高于Ⅲ、IV期,p<0.05,差异具有统计学意义,按病理类型比较3年、5年生存率p>0.05,无显著差异。结论对于外耳及中耳恶性肿瘤,早期诊断、早期治疗是提高生存率的关键,以手术为主的综合治疗是本病最佳治疗手段。预后与患者就诊时的临床分期、手术方式密切相关。

Objective To investigate the clinical type,stage,treatment and prognosis of malignant tumors of external and middle ear.Methods The clinical data of 23 patients with external auditory canal and middle ear malignant tumors who underwent surgery in our hospital from January 2008 to March 2020 were analyzed retrospectively.The pathological types were divided into 14 cases of squamous cell carcinoma,8 cases of adenoid cystic carcinoma,1 case of Merkel cell carcinoma,2 cases of clinical stage T1,7 cases of stage T2,10 cases of stage T3 and 4 cases of stage T4.5 cases underwent surgery alone,13 cases underwent surgery and postoperative radiotherapy,4 cases underwent surgery and postoperative radiotherapy and chemotherapy,and 1 case underwent radiotherapy and chemotherapy.Results The 3-year survival rate of the whole group was 69.6%,and the 5-year survival rate was 52.2%.The 3-year and 5-year survival rates of stage I and II patients were higher than those of stage III and IV,P<0.05.The difference was statistically significant.According to the pathological type,the 3-year and 5-year survival rates were p>0.05,and there was no significant difference.Conclusion Early diagnosis and treatment are the key to improve the survival rate of malignant tumors in the outer and middle ear.The comprehensive treatment of surgery combined with radiotherapy and chemotherapy is the best treatment for the disease.The prognosis is closely related to the clinical stage and operation mode.