鼻腔鼻窦腺样囊性癌的临床分析

Clinical analysis of adenoid cystic carcinoma of nasal cavity and sinuses

目的探讨鼻腔鼻窦腺样囊性癌(ACC)的临床特点及手术疗效分析。方法回顾性分析云南省第三人民医院2010年6月-2017年6月收治的31例病理确诊为鼻腔鼻窦ACC患者主要临床表现及生物学特性,针对不同部位、分期患者进行不同方式的手术及术后放疗。结果31例鼻腔鼻窦ACC患者随访30例,1例失访;3年生存率为87.1%(27/31),5年生存率为71.0%(22/31),3年局部复发率为16.2%(5/31),5年局部复发率为25.8%(8/31)。结论鼻腔鼻窦ACC生长部位深在,毗邻结构复杂,肿瘤的高侵袭性和沿神经浸润生长的习性,手术彻底切除较难,易复发。传统手术结合鼻内镜颅底技术以及神经追踪技术是减少复发、提高生存率的有效方法。

Objective To explore the clinical features and surgical efficacy of nasal cavity and sinuses adenoid cystic carcinoma(ACC).Methods The main clinical manifestations and biological characteristics of 31 patients with pathological diagnosis of ACC of nasal cavity and sinuses admitted to the Third People’s Hospital of Yunnan Province from June 2010 to June 2017 were retrospectively analyzed.Different methods of surgery and postoperative radiotherapy were carried out for patients with different parts and stages.Results After 31 patients were followed up,and one of them was lost to follow-up.The 3-year survival rate was 87.1%(27/31),the 5-year survival rate was 71.0%(22/31).The 3-year local recurrence rate was 16.2%(5/31),and the 5-year local recurrence rate was 25.8%(8/31).Conclusion The growth site of ACC of nasal cavity and sinuses is deep and its adjacent structure is complex.ACC tumors are highly invasive and grow along nerve infiltration,which is difficult to be completely resected and prone to recurrence.Traditional surgery combined with nasal endoscopic skull base technique and nerve tracking technique is an effective way to reduce recurrence and improve survival rate.