Treatment of lacrimal gland adenoid cystic carcinoma:a systematic review and Meta-analysis

AIM:To evaluate lacrimal gland adenoid cystic carcinoma(LGACC)of prognosis in patients who underwent different treatment regimens.METHODS:We searched PubMed,EMBASE,and the Cochrane Library for studies done on the treatment of LGACC,between January 1987 and April 2022.A Metaanalysis was conducted to pool the 5-year overall survival rate(OR),and the 5-year recurrence rate(RR)and 5-year metastasis rate(MR)were assessed.RESULTS:The 30 studies involved 585 patients were included in the Meta-analysis.The pooled 5-year OR with surgery alone was 50%,the 5-year RR was 63%,and the 5-year MR was 34%.The pooled 5-year OR with surgery and adjuvant radiotherapy combined was 67%(95%CI 61%,73%),the 5-year RR was 41%,and the 5-year MR was 35%.The pooled 5-year OR with surgery and adjuvant chemoradiotherapy combined was 72%(95%CI 59%,84%),the 5-year RR was 48%,and the 5-year MR was 36%.The pooled 5-year OR with surgery,intra-arterial cytoreductive chemotherapy,and adjuvant chemoradiotherapy combined was 78%(95%CI 68%,89%),the 5-year RR was 15%,and the 5-year MR was 27%.CONCLUSION:Comprehensive treatment is more effective than surgery alone.Surgery combined with intraarterial chemotherapy and adjuvant chemoradiotherapy seems to add value to the therapeutic effect of comprehensive treatment of LGACC but further high-quality research is required to validate this.

阿帕替尼治疗腺样囊性癌肺转移1例

腺样囊性癌(adenoid cystic carcinoma,ACC)是一种较少见的来源于腺体的恶性肿瘤,约占头颈部恶性肿瘤的1%[1]。其病程进展缓慢但极易侵袭,有较高的复发率和远处转移率,最常见的转移部位是肺[2]。对于ACC肺转移患者,目前并无特效药物。MYB基因表达失调是ACC患者最常见的突变。

Prognostic factors for lacrimal gland adenoid cystic carcinoma:a retrospective study in Chinese patients

AIM:To explore the prognostic factors for lacrimal gland adenoid cystic carcinoma(LGACC)in Chinese patients.METHODS:Clinical and histopathological data were reviewed in patients with pathologically confirmed LGACC.Local recurrence,metastasis,and disease-specific death were the main outcome measures.Univariate and multivariate analyses were performed by the Kaplan-Meier method and a Cox proportional hazard model.RESULTS:This retrospective cohort study included 45 patients with pathologically confirmed LGACC between January 2008 and June 2022.Tumor(T)classification(P=0.005),nodal metastasis(N)classification(P=0.018)and positive margin(P=0.008)were independent risk factors of recurrence;T(P=0.013)and N(P=0.003)classification and the basaloid tumor type(P=0.032)were independent risk factors for metastasis;T classification(P<0.001)was an independent factor of death of disease.In the further analysis,the durations from first surgery to radiotherapy is correlated with metastatic risk in LGACC patients with basaloid component(P=0.022).CONCLUSION:Histological subtype should be emphasized when evaluating prognosis and guiding treatment.Timely radiotherapy may reduce the risk of metastasis in patients with basaloid component.

Optimizing surgical approaches for lacrimal gland adenoid cystic carcinoma to minimize cross-organ invasion

AIM:To evaluate the outcomes of eye-sparing surgery for lacrimal gland adenoid cystic carcinoma and the impact on tumor recurrence and orbital integrity.METHODS:The study enrolled four patients with recurrent lacrimal gland adenoid cystic carcinoma.The outcome focused on the relevance of the integrity of the lateral orbital wall to the occurrence of extraorbital metastasis in the local recurrence of lacrimal gland adenoid cystic carcinoma.RESULTS:Three patients underwent eye-sparing surgery via lateral orbitotomy without postoperative radiotherapy,and one patient who underwent eye-sparing surgery via sub-brow approach.These four patients all demonstrated a recurrence involving the invasion of extraorbital tissues as metastatic form through surgical bone seams.CONCLUSION:Preserving intact orbital bone tissue is crucial for mitigating direct cross-organ metastasis of lacrimal gland adenoid cystic carcinoma.The findings suggest avoiding the lateral orbitotomy approach with no or limited orbital bone wall invasion.

Rare esophageal carcinoma-primary adenoid cystic carcinoma of the esophagus: A case report

BACKGROUND Esophageal adenoid cystic carcinoma(EACC)is an exceedingly rare malignant tumor of the esophagus,posing significant challenges in the clinic.CASE SUMMARY This report detailed the case of a 72-year-old male whose diagnosis of EACC was confirmed through postoperative histopathological examination.The patient underwent thoracoscopy-assisted radical resection of the esophageal tumor,coupled with lymph node dissection.Pathological findings revealed an adenoid cystic carcinoma infiltrating the entire layer of the muscularis propria,locally extending into the outer membrane of the esophageal fiber,involving the cardia and exhibiting no lymph node metastasis.The patient’s condition was classified as primary EACC,T3N0M0,per the American Joint Committee on Cancer(2017;8th edition).One month after surgery,the patient received postoperative adjuvant radiation therapy.CONCLUSION In addressing the rarity and high potential for biopsy misdiagnosis of EACC,this study delved into its diagnostic methods and treatment.

Anal metastasis in esophageal cancer:A case report

BACKGROUND Esophageal cancer is the sixth leading cause of cancer-related death and eighth most common cancer,affecting>450000 people worldwide.Esophageal squamous cell carcinoma is the most common histological type,whereas esophageal adenoid cystic carcinoma(EACC)is rare.The liver is the most common distant metastatic site in esophageal cancer.Anal metastasis is rare and has not been reported in clinical practice before.Here,we report anal metastases in a patient with EACC after regular chemotherapy and surgical resection.CASE SUMMARY A 61-year-old esophageal cancer patient was found to have lung and brain metastases during standardized treatment.The patient’s treatment plan was continuously adjusted according to the latest treatment guidelines.However,the patient subsequently noticed rectal bleeding and itching,and after obtaining pathology results at the local hospital,anal metastasis of esophageal cancer was diagnosed.CONCLUSION Postoperative pathology and immunohistochemistry confirmed EACC with rare anal metastasis.More exploration of EACC diagnosis and treatment is needed.

Ethmoidal Polyposis, Adenoid Hypertrophy and Tympanic Membrane Perforation—A Case Report

Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.

变应原筛查在儿童腺样体肥大中的研究

目的讨论变应原筛查在腺样体肥大患儿中的结果及临床意义。方法选取我院住院治疗的200例腺样体肥大患儿为腺样体肥大组,40例不伴腺样体肥大患儿为对照组,检测血清变应原筛查,对结果进行不同组间比较。结果腺样体肥大组总过敏原阳性率、食入性过敏原阳性率、吸入性过敏原阳性率均高于对照组(χ^2=8.048、8.000、6.938,P均<0.05);腺样体肥大组中总过敏原阳性率随年龄增长呈下降趋势(χ^2=13.132,P<0.05))。总过敏原阳性项数、食入性过敏原阳性项数、吸入性过敏原阳性项数腺样体肥大组均高于对照组(Z=2.925、2.631、2.362,P均<0.05);腺样体肥大组中总过敏原阳性项数中位数以3~6岁组最高(Z=2.582,P<0.05),食入性过敏原中牛奶、鸡蛋白、牛/羊肉组合均高于对照组。结论过敏原刺激是腺样体肥大的病因之一,患儿发病年龄越小,过敏易感性程度越高,其中牛奶、鸡蛋白、牛/羊肉组合类食入性过敏原刺激作用不容小觑。

鼻声反射在腺样体肥大儿童鼻通气功能评价中的应用

目前,鼻声反射技术已被广泛应用于评估鼻呼吸功能和鼻腔气道形态,使得临床上对鼻腔鼻咽部疾病的诊断、鼻腔手术方式的选择及术后疗效判定都具有了客观意义。本研究应用鼻声反射技术测量腺样体肥大患儿在腺样体切除手术前、后鼻腔通气功能的变化,从而探讨鼻声反射技术对于腺样体肥大的诊断和疗效判定方面的临床应用价值。

腺样体肥大患儿机体免疫功能变化研究

<正>腺样体也称咽扁桃体或增殖体,属于淋巴组织,表面呈桔瓣样。正常生理情况下,儿童6~7岁时腺样体发育至最大,青春期后逐渐萎缩,成人后基本消失~[1]。腺样体位于鼻咽顶后壁处,病理性肥大易引起鼻堵、张口呼吸、耳闷、听力下降等症状,最终造成慢性鼻-鼻窦炎、阻塞性睡眠呼吸暂停低通气综合征及分泌性中耳炎等疾病,给儿童的颌面骨发育、智力发育造成严重影响。

上颌窦气化程度与腺样体肥大相关性分析

上颌窦(maxillary sinus)是颌面部的重要解剖结构。很多研究表明成人上颌窦形态与睡眠呼吸暂停综合征密切相关[1]。一般认为其气化程度受遗传因素影响,也有学者研究同卵双生的双胞胎其上颌窦容积亦有差别,说明后天因素在气化过程中亦有重要作用。上颌窦形态异常造成的睡眠呼吸暂停综合征很难通过手术或其他方式来改善,因此发现影响上颌窦气化的因素并早期加以干预,具有重要临床意义。在临床工作中,

腺样体肥大儿童伴变应性鼻炎与分泌性中耳炎的相关性

分泌性中耳炎影响患儿听力,甚至影响语言、交流能力发育[1],若不能进行合理治疗,可能会造成儿童听力障碍以及言语与治疗发育不良。近几年临床研究显示,该疾病与儿童腺样体肥大以及变应性鼻炎存在一定关系。本文选择我院曾接收的存在腺样体肥大病史的患儿500例,对其变应性鼻炎、咽鼓管功能不良以及分泌性中耳炎相关性进行分析。1.1资料来源。2012年1月~2012年12月我院住院的腺样体肥大患儿500例,腺样体肥大程度为3~4度阻塞。

头颈部腺样囊性癌48例

腺样囊性癌(adenoid cystic carcinoma简称ACC)是涎腺常见的恶性肿瘤之一,多见于涎腺,也可发生于头颈其他部位。为了提高对本病的认识,根据我院治疗的病例,结合近年文献,对其临床特征、诊断和治疗等方面进行讨论。

抑癌基因与腺样囊性癌关系的研究进展

腺样囊性癌（adenoid cystic carcinoma,ACC）可发生于涎腺、泪腺、汗腺、乳腺以及上颌窦内、气管支气管等部位内壁的腺体等全身各部外分泌腺组织,因好发于大小涎腺中较小腺体,近年对涎腺来源的腺样囊性癌研究较为深入。腺样囊性癌生长速度缓慢,但由于其嗜神经血管生长及易远处转移的特点,使得腺样囊性癌易复发、早期转移率高,需要随访的周期较长。

Meta-analysis on the treatment of adenoid hypertrophy in children with integrated traditional Chinese and western medicine

Objective: To evaluate the effect of combined Chinese and western medicine on children withadenoidal hypertrophy. Methods: System comprehensive retrieve hownet (CNKI), a database of ten thousand China (WanFang), Chinese biomedical database (CBM), weipu database (VIP), PubMed, Embase and Cochrane library database, retrieval time from March 1, 2009 to December 31, 2019, the use of "Cochrane bias risk assessment tools to have included in the quality of literature evaluation, and to use the literature on into RevMan 5.3 software for Meta quantitative analysis. A total of 10 references were included in this study, and a total of 464 clinical cases were included in the total sample size for meta-analysis, including 242 in the experimental group and 222 in the control group. Results: The statistical data show that the total effective rate of combined traditional Chinese and western medicine for the treatment of adenoid hypertrophy in children is higher than that of western medicine alone (OR = 4.27, 95% CI: 2.50, 7.13, P <0.00001) The effect of nasal congestion caused by adenoid hypertrophy in children is better than that of western medicine alone (MD =-0.64, 95% CI [-0.94, -0.35], P <0.0001);the effect of improving snoring symptoms in children Better than using western medicine alone, the difference is statistically significant (MD =-0.66, 95% CI [-1.11, -0.21], P <0.01);the effect of reducing the relative ratio of adenoid and posterior nostril is better than that of pure The difference was statistically significant when treated with Chinese or Western medicine (MD =-0.18, 95% CI [-0.24, -0.12], P <0.00001). Conclusion: Based on the existing data and methods, traditional Chinese medicine combined with western medicine has a reliable effect on adenoid hypertrophy in children. It is superior to western medicine alone in terms of treatment efficiency and improvement of clinical symptoms, without serious adverse reactions.

外耳道腺样囊性癌误诊为外耳道炎2例

外耳道腺样囊性癌是一种罕见的头颈部涎腺肿瘤[1],原发于外耳道者罕见,在临床上误诊率很高,极易与外耳道炎混淆。现将我科收治2例外耳道腺样囊性癌病例报道如下。1临床资料病例1,患者,男,36岁,因右耳疼痛1年于2017-01-09收入青岛大学附属医院耳鼻咽喉头颈外科。患者1年前无明显诱因出现右耳疼痛,右外耳道肿胀伴右耳内有臭味,右侧面部及头部疼痛。无耳部流脓及渗液,无发热。

鼻内镜下吸切器治疗小儿腺样体肥大的疗效观察

目的探讨鼻内镜下吸切器治疗小儿腺样体肥大的疗效和安全性。方法对63例4～12岁腺样体肥大的患儿行鼻内镜下吸切器吸切治疗,所有病例鼻咽侧位片示腺样体厚度/鼻咽腔前后径≥0.71,纤维鼻咽镜检查腺样体阻塞后鼻孔的程度Ⅲ°52例;Ⅳ°11例。其中以鼻塞、流涕首诊15例,睡眠打鼾、憋气、张口呼吸39例,听力下降9例。11例并发扁桃体Ⅲ°,肥大者予以切除,3例鼓室积液同期行鼓膜置管术。结果 9例伴分泌性中耳炎复查声导抗鼓室功能曲线均呈A型,语频听力恢复到发病前水平,12例鼻腔通气正常,3例明显改善,37例睡眠打鼾和张口呼吸症状消失,2例好转。全部患儿术后无大出血、无鼻咽粘连和损伤等症状。结论手术是治疗临床症状明显的腺样体肥大的较好手段,鼻内镜下吸切器行腺样体切除与传统方法相比具有视野清晰、创伤小、出血少、不易残留、治疗效果好等优点,可以推广。

鼻内镜下鼻中隔腺样囊性癌1例

腺样囊性癌（adenoid cystic carcinoma，ACC）是耳鼻咽喉科少见的恶性肿瘤，鼻中隔腺样囊性癌罕见。我科最近诊治1例，报道如下。

Adenoid cystic carcinoma of breast: Recent advances

Adenoid cystic carcinoma(ACC) of the breast is a rare special subtype of breast cancer characterized by the presence of a dual cell population of luminal and basaloid cells arranged in specific growth patterns. Most breast cancers with triple-negative, basal-like breast features(i.e., tumors that are devoid of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression, and express basal cell markers) are generally high-grade tumors with an aggressive clinical course. Conversely, while ACCs also display a triple-negative, basal-like phenotype, they are usually low-grade and exhibit an indolent clinical behavior. Many discoveries regarding the molecular and genetic features of the ACC, including a specific chromosomal translocation t(6;9) that results in a MYB-NFIB fusion gene, have been made in recent years. This comprehensive review provides our experience with ACC of the breast, as well as an overview of clinical, histopathological, and molecular genetic features.