Different serum levels of IgG and complements and recurrence rates in IgG4-positive and negative lacrimal gland benign lymphoepithelial lesion

·AIM:To analyze the differences in immune indicators and prognosis between Ig G4-positive and negative lacrimal gland benign lymphoepithelial lesion(LGBLEL).·METHODS:This was a single-center retrospective clinical study including 105 cases of Ig G4-positive LGBLEL and 41 cases of Ig G4-negative LGBLEL.Basic information,related indicators of peripheral venous blood samples using immunoscattering turbidimetry,treatment(partial surgical excision and glucocorticoid therapy)and prognosis(recurrence and death)were collected.Survival curves for recurrence were created using the Kaplan-Meier analysis.Univariate analysis and multivariate regression analysis were used to analyze prognostic factors.·RESULTS:The mean age was 50.10±14.23y and 44.76±11.43y(P=0.033)in Ig G4-positive and negative group respectively.The serum C3 and C4 was lower in Ig G4-positive group(P=0.005,P=0.002),while the serum Ig G and Ig G2 was higher in Ig G4-positive group(P=0.000 and P=0.008).Twenty-one cases had recurrence in Ig G4-positive group and 3 cases recurrence in Ig G4-negative group.The 5-year recurrence-free cumulative percentages of Ig G4-positive group was 81.85%,and 83.46%in the Ig G-negative group(P=0.216).The history of preoperative glucocorticoid therapy,serum C4,Ig G1 and Ig G2 were the factors affecting recurrence in Ig G4-positive group,while serum C4,and Ig G1 were the factors affecting recurrence of LGBLEL.·CONCLUSION:Serum C4 and Ig G1 are the factors affecting recurrence of LGBLEL,while the Ig G4 does not affect recurrence of LGBLEL.

Association analysis of BclI with benign lymphoepithelial lesions of the lacrimal gland and glucocorticoids resistance

AIM:To evaluate the relationship between gene polymorphism(BclI,ER22/23EK,N363S)and the occurrence,progression and sensitivity to glucocorticoid of lacrimal gland benign lymphoepithelial lesion(LGBLEL).METHODS:Clinical peripheral blood samples of 52 LGBLEL patients and 10 normal volunteers were collected for DNA extraction and polymerase chain reaction sequencing to analyze single nucleotide polymorphism(SNP)genotypes.The lacrimal tissues of LGBLEL were surgically removed and made into paraffin sections for subsequent hematoxylin-eosin(HE)and Masson staining analysis.The duration of disease and hormone use of LGBLEL patients from diagnosis to surgery were also analyzed.The Meta-analysis follows PRISMA guidelines to conducted a systematic review of human studies investigating the relationship between the NR3C1 BclI polymorphism and glucocorticoids(GCs)sensitivity.RESULTS:There was no association between ER22/23EK or N363S and the occurrence of LGBLEL or GCs sensitivity(P>0.05);BclI GC genotype was closely related to GCs resistance(P=0.03)as is the minor allele C(P=0.0017).The HE staining and Masson staining showed that the GC genotype of BclI remarkably slowed down the disease progression and reduced fibrosis(P<0.05),especially for GCs-dependent patients(P<0.0001).Meta-analysis showed that BclI was not significantly associated with GCs responsiveness.CONCLUSION:The LGBLEL patients who carry the NR3C1 BclI allele C may be more sensitive to GCs and associated with lower fibrosis and slower disease progression.The results may guide the clinical treatment strategy for the LGBLEL patients.

Benign lymphoepithelial cyst of parotid gland without human immunodeficiency virus infection:A case report

BACKGROUND Benign lymphoepithelial cyst(BLEC)of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus(HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients.The main presentation is a slow-growing,painless mass,and secondary infection may cause acute inflammatory symptoms.CASE SUMMARY A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck.On physical examination,a mass similar in size and shape to a quail egg was found in the left parotid gland.The mass was tough,without tenderness,and easily moveable.The results of HIV tests,including antibody and nucleic acid tests and CD4+T cell examination,were negative.Imaging examination revealed a left parotid gland mass.The patient underwent surgical treatment,and BLEC was diagnosed based on postoperative pathology.After 2years of follow-up,the patient survived well without related discomfort.CONCLUSION The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.

Association of TCR-signaling pathway with the development of lacrimal gland benign lymphoepithelial lesions

·AIM: To identify the association of the T cell receptor(TCR) signaling with the development of benign lymphoepithelial lesions(BLEL) of the lacrimal gland.· METHODS: We collected affected lacrimal gland tissues from 9 patients who underwent dacryoadenectomy in the Capital Medical University Beijing Tongren Hospital Eye Center between August2010 and March 2013 and were confirmed to have lacrimal gland BLEL by histopathological analysis. Tumor tissues from 9 patients with orbital cavernous hemangioma were also collected and used as control.Whole genome gene expression microarray was used to compare gene expression profiles of affected lacrimal gland tissues from patients with lacrimal gland BLEL to those from of orbital cavernous hemangiomas.Differential expression of TCR pathway genes between these tissues was confirmed by polymerase chain reaction(PCR) and immunohistochemistry.·RESULTS: Microarray analysis showed that in lacrimal glands with BLEL, 32 signaling pathways were enriched in the upregulated genes, while 25 signaling pathways were enriched in the downregulated genes. In-depth analysis of the microarray data showed that the expression of 27 genes of the TCR signaling pathway increased significantly. To verify the differential expression of three of these genes, CD3, CD4, and interleukin(IL)-10, reverse transcription-PCR(RT-PCR)and immunohistochemistry assays were performed. RT-PCR analysis showed that CD3 and CD4 were expressed in the lacrimal glands with BLEL, but IL-10 was not expressed. Immunohistochemistry confirmed that CD3 and CD4 proteins were also present, but IL-10 protein was not. CD3, CD4, or IL-10 expression was not found in the orbital cavernous hemangiomas with either RT-PCR or immunohistochemistry.· CONCLUSION: TCR signaling pathway might be involved in the pathogenesis of lacrimal gland BLEL.

Association of the macrophage migration inhibitory factor promoter polymorphisms with benign lymphoepithelial lesion of lacrimal gland

AIM： To identify the association of the macrophage migration inhibitory factor （MIF） gene polymorphism with the susceptibility of benign lymphoepithelial lesions （BLEL） of the lacrimal gland. METHODS： A total of 40 BLEL of lacrimal gland cases were matched with 40 healthy subjects （HS）. Extraction the plasma and whole blood DNA of patients of lacrimal gland BLEL and HS. Elisa and polymerase chain reaction was used to determine in plasma contents of MIF and MIF gene SNP-173G〉C and STR -794 CATT（8） polymorphism, respectively. RESULTS： The MIF levels in plasma were significantly higher in patients with lacrimal gland BI.EL versus HS （P〈0.001）. The -173 G〉C MIF polymorphism was significantly associated with lacrimal gland BLEL, with a significantly higher frequency of the C allele in lacrimal gland BLEL patients compared with HS （OR=2.38, 95% C1=1.07-5.31, P=0.032）, and the -173 C/x is more frequent in patients than in HS, P=0.037. Besides, we found that the carriage rate of the MIF -173C/x is associated with higher plasma levels of MIF in the BLEI. of lacrimal gland. CONCLUSION： MIF -173G/C variants play an insidious role in susceptibility of BLEL of lacrimal gland. Otherwise,there is no statistically significant correlation exists between MIF-794 CATT （） and BLEL of lacrimal gland.

The value of MSCT in diagnosis of parotid benign tumor (An analysis of 84 cases)

Objective:The purpose of the study was to assess diagnostic performance of MSCT images in patients with parotid benign tumors and provide useful criteria for the characterization of their various pathological types preoperatively. Methods: Retrospectively analyzed clinical and imaging characteristics of 84 cases of pathologically confirmed primary parotid benign tumors. MSCT plain-scan and enhanced-scan were performed in all cases. After injection of 50 mL contrast material at a rate of 3.5 mL/s,spiral CT scans were obtained at arterial and venous phases with scanning delay of 30 s and 75 s,respectively. The attenuation change and enhancement patterns in the tumors were assessed. Quantitatively assess the increased CT number of the tumors in different enhanced-phases compared with the plain-scan and the ratio of increased CT number at venous phase scanning to that at arterial phase scanning also was calculated. Results:In all of 84 cases,40 cases were solitary pleomorphic adenomas,29 cases were adenolyphomas,6 cases were multiple tumors,2 cases were bilateral,15 cases were Basal cell tumor,and one of them had two small lesions. The diameter was 1–5 cm in most of cases,whose margin was smooth and clear,cystic changes in some cases. At two-phase scans,pleomorphic adenomas showed a pattern of slight enhancement and venous enhancement,adenolymphomas showed a pattern of strong enhancement at arterial phase scanning with a decrease at venous phase scanning,basal cell tumor showed a pattern of persistent strong enhancement with commonly significant cystic areas. The ratio of increased CT number was significant different between adenolymphomas and other pathological types. Conclusion: The evaluation of enhancement patterns at two-phase enhanced-scan MSCT is helpful in the differential diagnosis of parotid gland benign tumors.

Hybrid intercalated duct lesion of the parotid:A case report

BACKGROUND Intercalated duct lesions(IDLs)are considered relatively benign and rare tumors of salivary glands,that were only described recently.Their histopathological appearance may range from ductal hyperplasia to encapsulated adenoma with hybrid patterns of both variants.It is thought that IDLs may be the precursor for malignant proliferations,therefore their correct diagnosis remains crucial for proper lesion management.It is the first reported IDL case arising from the accessory parotid gland(APG),which stands for less frequent but higher malignancy rate tumor developmental area.CASE SUMMARY A 24-years-old male with no accompanying diseases was referred to the hospital with a painless nodule on the right cheek.On physical examination,the stiff,immobile,and painless mass was palpable in the anterior portion of the right parotideomasseteric region,just superior to the parotid duct.Ultrasound examination demonstrated 1.5 cm×1.0 cm hypoechogenic mass on the anterior part of the right parotid gland.Ultrasound-guided fine needle aspiration cytology,followed by liquid-based fine needle aspiration biopsy were performed.However,the results were uninformative.A contrast-enhanced magnetic res-onance imaging(MRI)of the parotid was obtained,demonstrating a 1.5 cm×1.0 cm×0.5 cm tumor with high intensity capsule together with low intensity core in the very anterior part of right superficial lobe,situated in the APG.An MRI features were uncharacteristic to common parotid tumors,therefore surgical resection followed up.After histopathological examination,the final diagnosis of hybrid IDL was confirmed.CONCLUSION Fine needle aspiration biopsy might not always be diagnostic,and given the malignant potential,the surgical resection of such lesion remains the treatment of choice.

Intermittent facial spasms as the presenting sign of a recurrent pleomorphic adenoma

The intimate anatomical relationship of the facial nerve to the parotid parenchyma has a significant influence on the presenting signs and symptoms, diagnosis and treatment of parotid neoplasms.However, to our knowledge, hyperactivity of this nerve, presenting as facial spasm, has never been described as the presenting sign or symptom of a parotid malignancy.We report a case of carcinoma arising in a recurrent pleomorphic adenoma of the left parotid gland(i.e., carcinoma ex pleomorphic adenoma) that presented with hemifacial spasms.We outline the differential diagnosis of hemifacial spasm as well as a proposed pathophysiology.Facial paralysis, lymph node enlargement, skin involvement, and pain have all been associated with parotid malignancies.To date the development of facial spasm has not been reported with parotid malignancies.The most common etiologies for hemifacial spasm are vascular compression of the ipsilateral facial nerve at the cerebellopontine angle(termed primary or idiopathic)(62%), hereditary(2%), secondary to Bell's palsy or facial nerve injury(17%), and hemifacial spasm mimickers(psychogenic, tics, dystonia, myoclonus, myokymia, myorthythmia, and hemimasticatory spasm)(17%).Hemifacial spasm has not been reported in association with a malignant parotid tumor but must be considered in the differential diagnosis of this presenting symptom.

Clinical Research on Benign Lymphoepithelial Lesions of Lacrimal Gland in 20 Chinese Patients

Background：Benign lymphoepithelial lesion （BLEL） is characterized by symmetric bilateral swelling of the lacrimal and salivary glands and considered a subtype of immunoglobulin G4 （IgG4）-related sclerosing disease,the etiology and pathogenesis of which has not been determined.The purpose of the present study was to analyze the clinical features of BLEL in the lacrimal gland and the relationship between the serum level of IgG4 and BLEL.Methods：Twenty consecutive patients with BLEL diagnosed in Department of Ophthalmology at Beijing Tongren Hospital,Capital Medical University between January 2012 and December 2013 were observed.The clinical features,imaging findings,laboratory tests,treatments and follow-up status of these 20 consecutive patients were analyzed.Results：In all 20 patients,the ratio of male to female was 1：4,the ages ranged from 28 to 57 years,the ratio of unilateral to bilateral eyes involvement was 1：4,and painless uncongested symmetrical swelling of the upper eyelid was the main clinical manifestation.Orbital magnetic resonance imaging （MRI） showed that all patients involved lacrimal gland,which were obviously enlarged with equal signals in T1W images and T2W images and obvious enhancement on contrast MRI.Extraocular muscles were involved in 5 patients,salivary gland in 8 patients,and frontal nerve in 3 patients.Serum IgG4 concentration was elevated in 18 patients.The treatment strategy mainly included surgery and steroid administration.Three patients were lost to follow-up,17 patients reached complete response,and no recurrence was observed.Conclusions：Eyelid swelling is the typical symptom of BLEL.Most of the patients involved bilateral lacrimal glands.High serum IgG4 level and abundant IgG4-positive plasma cell infiltration are the important features,which can be found in most of BLEL patients.Surgery combined with glucocorticoids is an efficient treatment strategy.

腮腺深叶良性肿瘤:与定位和手术入路相关的分类

目的:腮腺深叶良性肿瘤(benign deep lobe parotid tumors,BDLPTs)具有多种临床表现和影像学特征,与选择合适的手术入路密切相关,本研究旨在探讨不同类型BDLPTs手术方式的差异。方法:选取2014年8月—2020年8月因腮腺区肿物就诊于北京大学口腔医院并行手术治疗且病理诊断为BDLPTs的75例患者,回顾性评估CT影像资料,根据肿瘤与各种结构的解剖关系将BDLPTs分为4类,探讨每种类型肿瘤的手术治疗方法。采用SPSS 24.0软件包对数据进行统计学分析。结果:Ⅰ型BDLPTs(14/75,18.7%)完全位于下颌支和茎突下颌间隙内侧,瘤体增大时突向咽旁间隙。Ⅱ型BDLPTs(19/75,25.3%)位于下颌后间隙,以下颌支、茎突下颌间隙、乳突和下颌后静脉为界。Ⅲ型BDLPTs(27/75,36.0%)呈膨胀型生长,横穿茎突下颌间隙,从下颌后静脉延伸至咽旁间隙。Ⅳ型BDLPTs(15/75,20%)位于耳垂下方、面神经和下颌后静脉深部。经下颌骨劈开入路主要用于Ⅰ型病例(10/14),Ⅲ型病例采用腮腺入路(14例)、下颌入路(11例)和腮腺-下颌联合入路(2例),Ⅱ型和IV型病例经腮腺入路同时行腮腺切除术。结论:BDLPTs分类可为术前制定治疗计划提供有价值的见解和实践指导。

不同手术切口对腮腺良性肿瘤患者血清疼痛介质、氧化应激的影响

目的分析不同手术切口对腮腺良性肿瘤患者血清疼痛介质、氧化应激的影响。方法回顾性分析2016年1月至2023年1月在赞比亚Ndola教学医院、赞比亚恩都拉铜带大学教学医院、河南省人民医院、河南科技大学第二附属医院接受腮腺良性肿瘤切除手术治疗的65例腮腺良性肿瘤患者临床资料,按照手术切口分为对照组(40例,术中接受传统S形切口操作)、观察组[25例,术中行改良耳前-耳后发际切口(又称改良V形切口)]。对比两组手术指标、术区面神经损伤情况、血清疼痛介质、氧化应激指标、手术瘢痕情况、并发症发生率。结果观察组手术用时、术后引流量与对照组相比,差异无统计学意义(P>0.05);观察组术中出血量比对照组少(P<0.05);观察组术后第7天House-Brackmann分级法评分、超氧化物歧化酶、谷胱甘肽过氧化物酶比对照组高,血清前列腺素E 2、P物质、β-内啡肽水平比对照组低(P<0.05);观察组术后第1个月瘢痕美容评估与评级量表评分比对照组高(P<0.05);观察组并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论与传统S形切口操作相比,实施改良V形操作可有效减少术中出血量,减轻面部神经损伤程度,降低术后疼痛及氧化应激反应程度,改善手术瘢痕情况。

改良切口与传统切口治疗腮腺良性肿瘤的疗效比较

目的 基于多准则决策模型探讨改良切口与传统切口治疗腮腺良性肿瘤的疗效。方法 回顾性选择2019年4月至2022年4月于成都市中西医结合医院采用手术治疗的98例腮腺良性肿瘤患者为研究对象,将采用倒“V”型切口治疗的患者作为改良组,采用“S”形切口治疗的患者作为传统组,两组各49例。比较两组年龄、性别、病理结果、病变部位、手术时间、手术出血量等一般资料;比较两组视觉模拟评分法(VAS)评分、焦虑自评量表(SAS)评分、术后面瘫分级、术后3个月的疗效;比较两组面瘫、涎瘘等术后并发症发生情况。建立改良术式治疗腮腺良性肿瘤的多准则决策模型,并对两组效益值、风险值及决策模型的稳定性进行评价。结果 改良组患者的手术切口长度、术后皮肤表面瘢痕长度、VAS评分及SAS评分与传统组比较,差异均有统计学意义(P<0.05);改良组与传统组的平均效益值分别为83、55,改良组的效益值100%优于传统组;改良组与传统组的平均风险值分别为75、57,改良组的风险值100%低于传统组;改良组与传统组的平均效益-风险总值分别为79、56,改良组的总效益-风险值高于传统组的概率为100%;多准则决策评价模型稳定性较好。结论 倒“V”型切口能明显改善腮腺良性肿瘤患者术后面颈部的美观度,提高患者的生活质量及幸福指数。

应变弹性成像联合对比增强超声对腮腺良恶性肿瘤的诊断价值

目的探讨应变弹性成像(SE)联合对比增强超声(CEUS)对腮腺良恶性肿瘤的诊断价值。方法回顾性分析2015年2月至2023年5月于医院接受诊疗的327例腮腺肿瘤患者的临床资料。采集患者治疗前的SE和CEUS检查数据。根据活检或术后病理组织学检查结果将患者分为良性组(263例)和恶性组(64例)。比较两组性别、年龄、常规超声影像特征及SE、CEUS影像特征,并分析SE、CEUS单独及联合诊断腮腺良恶性肿瘤的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)。结果两组病灶数量、最大直径、形态、边缘、回声特征、钙化情况比较,差异有统计学意义(P<0.05);两组SE评分、边缘增强清晰度、环状增强、增强大小、增强模式比较,差异有统计学意义(P<0.05);SE联合CEUS诊断腮腺良恶性肿瘤的灵敏度、特异度和PPV均高于SE、CEUS单独诊断,差异有统计学意义(P<0.05)。结论腮腺良恶性肿瘤的常规超声影像特征及SE、CEUS影像特征有所不同,SE、CEUS均对腮腺良恶性肿瘤具有一定诊断价值,联合诊断可提高诊断灵敏度、特异度和PPV。

腔镜下耳后发际线径路面神经顺行解剖后腮腺良性肿瘤切除术的临床分析

目的探讨腔镜辅助下耳后发际线径路面神经顺行解剖后腮腺肿瘤切除手术的临床效果。方法选择2022年7月—2022年9月诊治的3例腮腺肿瘤位于浅叶并且直径小于3cm患者,采用发际线径路,在全腔镜下顺行解剖面神经后,行腮腺肿瘤和部分浅叶切除治疗。结果3例患者均顺利完成手术,均无术后出血、涎瘘及面瘫,收到良好的美容效果。结论腔镜下耳后发际线径路面神经顺行解剖后腮腺良性肿物切除术是一种安全可行、有良好美容效果的手术方式。

双侧腮腺多灶性腺瘤样嗜酸细胞增生1例报告及文献复习

多灶性腺瘤样嗜酸细胞增生是一种罕见的唾液腺病变。本文报告1例双侧腮腺多灶性腺瘤样嗜酸细胞增生病变,并结合文献探讨其临床病理特征、诊断、治疗及预后,旨在为临床诊治提供参考。

腮腺术后压迫装置加压包扎对腮腺良性肿瘤患者术后咀嚼功能、涎瘘发生率的影响

目的研究腮腺术后压迫装置加压包扎对腮腺良性肿瘤患者术后咀嚼功能、涎瘘发生率的影响。方法将我院2021年3月至2022年2月收治的65例腮腺良性肿瘤术后患者随机分为对照组(n=32)和观察组(n=33),对照组使用常规医用绷带进行术区加压包扎,观察组使用腮腺手术术后包扎压迫装置进行术区加压包扎,比较两组患者术后并发症发生情况、疼痛程度、咀嚼功能及生活质量。结果两组患者术后并发症发生率比较差异无统计学意义(P>0.05);观察组术后1 d、3 d、术后7 d、术后14 d疼痛评分小于对照组(P<0.05),且组间、时间点比较差异有统计学意义(P<0.05);观察组患者术后15 d、术后20 d、术后30 d的咀嚼效率均高于对照组,差异有统计学意义(P<0.05),且组间、时间点比较差异有统计学意义(P<0.05);出院时,观察组“吞咽”“咀嚼”“语言”“唾液”“情绪”等项评分高于对照组,差异有统计学意义(P<0.05)。结论腮腺术后压迫装置加压包扎可减轻腮腺良性肿瘤患者术后患者疼痛、不适感,改善患者咀嚼功能和生活质量,是一种有效的包扎装置。

耳后小切口切除术对腮腺良性肿瘤患者围术期指标及生活质量的影响

目的探讨腮腺良性肿瘤患者采用耳后小切口切除术治疗对其围术期指标及生活质量的影响。方法选取2020年8月—2021年11月郑州大学附属洛阳中心医院收治的70例腮腺良性肿瘤患者作为研究对象,按照随机数字表法分成观察组(n=35)与对照组(n=35)。对照组患者给予传统切除术,观察组患者给予耳后小切口切除术,比较2组患者的围术期指标、康复情况、生活质量及并发症发生情况。结果2组患者术中出血量比较,差异无统计学意义(P>0.05);而与对照组比较,观察组患者手术时间更长,引流量更少,引流时间、住院时间更短,且差异均有统计学意义(P<0.05)。与对照组比较,观察组患者术后3、6个月的House-Brackmann面神经功能分级标准(H-BFGS)、视觉模拟评分法(VAS)、瘢痕美容评估与评级量表(SCAR)评分更低,且差异均有统计学意义(P<0.05)。2组患者术前世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分比较,差异无统计学意义(P>0.05);术后3个月,2组患者WHOQOL-BREF评分均较术前有所提高(P<0.05),且观察组患者量表各维度得分均高于对照组(P<0.05)。对照组患者并发症发生率为22.86%,观察组患者并发症发生率为5.72%,二者比较,差异有统计学意义(P<0.05)。结论腮腺良性肿瘤患者采用耳后小切口切除术治疗,能够改善患者围术期指标及康复情况,提高患者生活质量,降低并发症发生风险,值得推广。

CT检查在腮腺良恶性肿瘤鉴别诊断中的应用效果

目的:探讨CT检查在腮腺良恶性肿瘤鉴别诊断中的应用效果。方法:选取2019年4月—2022年4月睢宁县人民医院收治的腮腺肿瘤患者40例作为研究对象,均进行CT平扫与增强扫描,以病理诊断结果为“金标准”,分析CT检查对腮腺肿瘤的诊断效能(检出率、漏诊率、误诊率),比较良恶性腮腺肿瘤的CT征象。结果:CT结果显示,40例患者中,良性肿瘤23例,恶性肿瘤6例,检出率为72.8%(29/40),误诊率为5.0%(2/40),漏诊率为22.5%(9/40);CT与病理检查对不同类型腮腺肿瘤的检出率比较,差异无统计学意义(P>0.05)。良性腮腺肿瘤部位以浅叶为主,形态较为规则,且密度均匀,边界清晰,多数未出现钙化,囊变分级以1~2级为主,平扫和加强CT值较低;恶性肿瘤部位以深叶为主,形态不规则,密度不均匀,边界不清晰,多数出现钙化,囊变分级以3~4级为主,平扫和加强CT值较高。良恶性腮腺肿瘤的CT征象比较,差异有统计学意义(P<0.05)。结论:CT在腮腺良恶性肿瘤鉴别诊断中的应用价值显著,检出率较高,误诊率较低,能够清晰显示肿瘤部位、形态、边界、密度及强化程度等信息,但存在一定漏诊情况,针对疑似恶性腮腺肿瘤患者仍需进一步检查。

磁共振扩散峰度成像鉴别诊断腮腺肿瘤良恶性的价值研究

目的分析磁共振扩散峰度成像(DKI)对腮腺肿瘤良恶性的诊断价值。方法选取2018年2月—2020年2月上饶市立医院收治的经手术确认的60例腮腺肿瘤患者作为研究对象,均实施DKI检查,判断DKI检查对腮腺肿瘤良恶性的临床诊断价值。结果经手术证实,60例腮腺肿瘤患者中良性肿瘤患者42例,恶性肿瘤患者18例。DKI检查结果显示,包含腺淋巴瘤的良性肿瘤平均峰度图(kmean)、径向峰度图(krad)及峰度各项异性图(kax)数值均明显小于恶性肿瘤,但差异无统计学意义(P>0.05);非腺淋巴瘤的良性肿瘤3项数值均小于恶性肿瘤,差异有统计学意义(P<0.05)。结论通过对腮腺肿瘤患者实施DKI并分析kax、kmean、krad 3项数值,可为肿瘤良恶性诊断提供较为有效的依据,有利于指导后续手术方案的制定,具有较高的临床应用价值。

隐蔽切口在良性腮腺肿瘤切除术中的应用

目的比较隐蔽切口和常规耳下颈部切口在良性腮腺肿瘤切除术中的应用效果。方法回顾性分析2019年1月至2022年1月该院收治的143例良性腮腺肿瘤患者的临床资料,根据治疗方式将患者分为对照组(120例)和观察组(23例)。对照组为常规耳下颈部切口手术,观察组为隐蔽切口手术。比较两组手术指标、肿瘤复发率、生活质量评分、不良反应。结果观察组手术时间、术中出血量、术后48 h引流量均低于对照组,差异均有统计学意义(P<0.05);观察组疼痛、情绪、美容效果评分均高于对照组,差异均有统计学意义(P<0.05);对照组不良反应发生率为31.67%,高于观察组的8.70%,差异有统计学意义(P<0.05);对照组复发率与观察组比较,差异无统计学意义(P>0.05)。结论与常规耳下颈部切口相比,隐蔽切口行良性腮腺肿瘤切除术可缩短手术时间、减少术中出血量及术后引流量,提高患者生活质量,降低不良反应发生率,值得临床推广应用。