北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (1): 30-34. doi: 10.19723/j.issn.1671-167X.2020.01.005
Ye ZHANG,Ni ZHANG,Xiao-xiao LIU,Chuan-xiang ZHOU()
摘要:
目的:回顾性分析唾液腺腺样囊性癌颈部淋巴结转移的发病率及其临床病理特征。方法:回顾性分析2001年1月至2019年1月在北京大学口腔医院诊治并经病理确诊为腺样囊性癌的798例患者的临床病理资料,对82例发生颈部淋巴结转移的患者进行详细的临床病理及统计学分析。结果:纳入研究的腺样囊性癌患者798例,腭部、舌下口底区域和腮腺区是腺样囊性癌常见的发病部位。经病理学检查证实发生颈部淋巴结转移者82例,总体转移率约10.3%(82/798),其中原发于颌下腺、舌下口底区及舌部的颈部淋巴结转移率较高,分别为20.8%、16.1%、15.1%,而腭部、腮腺原发病例颈部淋巴结转移率较低,分别为6.1%、3.4%。颈Ⅰ、Ⅱ区为常见转移区域,极少累及Ⅳ、Ⅴ区淋巴结。主要转移模式是由癌细胞沿经典的淋巴管/血管通路转移(70.7%),部分颌下及舌下病例不除外直接侵犯淋巴结。82例伴淋巴结转移的患者5年和10年总生存率分别为77.4% 和 20.6%。淋巴结转移阳性组患者总生存率和无瘤生存率均显著低于转移阴性组,且组织学呈现实性型的腺样囊性癌颈部淋巴结转移率显著高于筛孔型和管状型肿瘤。结论:舌下、口底及颌下腺为唾液腺腺样囊性癌颈部淋巴转移常见原发部位,实性型组织学结构与转移率显著正相关,在临床诊治及随访中需要更多关注。
中图分类号:
[1] | Tian Z, Li L, Wang L , et al. Salivary gland neoplasms in oral and maxillofacial regions: A 23-year retrospective study of 6 982 cases in an eastern Chinese population[J]. Int J Oral Maxillofac Surg, 2010,39(3):235-242. |
[2] | Gao M, Hao Y, Huang MX , et al. Clinicopathological study of distant metastases of salivary adenoid cystic carcinoma[J]. Int J Oral Maxillofac Surg, 2013,42(8):923-928. |
[3] | Shen C, Xu T, Huang C , et al. Treatment outcomes and prognostic features in adenoid cystic carcinoma originated from the head and neck[J]. Oral Oncol, 2012,48(5):445-449. |
[4] | Lloyd S, Yu JB, Wilson LD , et al. Determinants and patterns of survival in adenoid cystic carcinoma of the head and neck, including an analysis of adjuvant radiation therapy[J]. Am J Clin Oncol, 2011,34(1):76-81. |
[5] | Bhayani MK, Yener M, El-Naggar A , et al. Prognosis and risk factors for early-stage adenoid cystic carcinoma of the major salivary glands[J]. Cancer, 2012,118(11):2872-2878. |
[6] | Armstrong JG, Harrison LB, Thaler HT , et al. The indications for elective treatment of the neck in cancer of the major salivary glands[J]. Cancer, 1992,69(3):615-619. |
[7] | Suárez C, Barnes L, Silver CE , et al. Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international review[J]. Auris Nasus Larynx, 2016,43(5):477-484. |
[8] | Ardekian L, Kokemueller H, Eckardt A , et al. Adenoid cystic carcinoma of the head and neck: A 20 years experience[J]. Int J Oral Maxillofac Surg, 2004,33(1):25-31. |
[9] | Bianchi B, Copelli C, Cocchi R , et al. Adenoid cystic carcinoma of intraoral minor salivary glands[J]. Oral Oncol, 2008,44(11):1026-1031. |
[10] | Coca-Pelaz A, Rodrigo JP, Bradley PJ , et al. Adenoid cystic carcinoma of the head and neck: An update[J]. Oral Oncol, 2015,51(7):652-661. |
[11] | Zhang M, Xu ZF, Tao Y , et al. Clinical analysis of 25 patients with glossal adenoid cystic carcinoma[J]. Int J Stomt, 2009,36(2):148-151. |
[12] | Min R, Siyi L, Wenjun Y , et al. Salivary gland adenoid cystic carcinoma with cervical lymph node metastasis: A preliminary study of 62 cases[J]. Int J Oral Maxillofac Surg, 2012,41(8):952-957. |
[13] | Amit M, Binenbaum Y, Sharma K , et al. Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma. An international collaborative study[J]. Head Neck, 2015,37(7):1032-1037. |
[14] | Weinreb I, Lee SY, Kim BH , et al. Nineteen-year oncologic outcomes and the benefit of elective neck dissection in salivary gland adenoid cystic carcinoma[J]. Head Neck, 2014,36(12):1796-1801. |
[15] | Ali S, Palmer FL, Katabi N , et al. Long-term local control rates of patients with adenoid cystic carcinoma of the head and neck managed by surgery and postoperative radiation[J]. Laryngoscope, 2017,127(10):2265-2269. |
[16] | Nakada M, Nishizaki K, Akagi H , et al. Oncocytic carcinoma of the submandibular gland: a case report and literature review[J]. J Oral Pathol Med, 1998,27(5):225-228. |
[17] | Amit M, Na’ara S, Sharma K , et al. Elective neck dissection in patients with head and neck adenoid cystic carcinoma: An international collaborative study[J]. Ann Surg Oncol, 2015,22(4):1353-1359. |
[1] | 俞光岩,柳登高,李巍,洪霞,张严妍,朱文瑄,张可夫,李潇,栗占国,刘燕鹰,陈艳,高岩,苏家增. 3类新型慢性唾液腺炎的诊断和治疗[J]. 北京大学学报(医学版), 2022, 54(1): 13-17. |
[2] | 薛江,张建运,时瑞瑞,谢晓艳,白嘉英,李铁军. 105例口腔颅颌面部纤维性结构不良的临床病理分析[J]. 北京大学学报(医学版), 2022, 54(1): 54-61. |
[3] | 周传香,周正,张晔,刘晓筱,高岩. 28例口腔基底样鳞状细胞癌的临床病理分析[J]. 北京大学学报(医学版), 2022, 54(1): 62-67. |
[4] | 苏俊琪,宋扬,谢尚. 口腔鳞状细胞癌患者修复重建术后感染的病原学特征及感染风险预测模型的构建[J]. 北京大学学报(医学版), 2022, 54(1): 68-76. |
[5] | 魏慧,罗增,次旦央宗,白玛央金. 高原地区不同海拔高度腹型过敏性紫癜患者临床特征分析[J]. 北京大学学报(医学版), 2021, 53(6): 1072-1077. |
[6] | 宋志博,耿研,邓雪蓉,张晓慧,张卓莉. 肌肉骨骼超声在指导银屑病关节炎临床分型中的价值[J]. 北京大学学报(医学版), 2021, 53(6): 1061-1066. |
[7] | 穆东亮,薛铖,安彬,王东信. 硬膜外阻滞与结直肠癌患者术后远期生存状态的关系:一项倾向性评分匹配的回顾性研究[J]. 北京大学学报(医学版), 2021, 53(6): 1152-1158. |
[8] | 叶剑飞,赵磊,王国良,洪锴,马潞林. 睾丸横纹肌肉瘤的诊治分析[J]. 北京大学学报(医学版), 2021, 53(6): 1178-1182. |
[9] | 刘梅歌,方朴,王严,丛璐,范洋溢,袁远,徐燕,张俊,洪道俊. 远端型遗传性运动神经病8例的临床、病理及遗传学特点[J]. 北京大学学报(医学版), 2021, 53(5): 957-963. |
[10] | 田雨,程晓悦,贺慧颖,王国良,马潞林. 肾细胞癌合并尿路瘤栓的临床病理特征: 6例报道及文献回顾[J]. 北京大学学报(医学版), 2021, 53(5): 928-932. |
[11] | 蒋艳芳,王健,王永健,刘佳,裴殷,刘晓鹏,敖英芳,马勇. 前交叉韧带翻修重建术后中长期临床疗效及影响因素[J]. 北京大学学报(医学版), 2021, 53(5): 857-863. |
[12] | 庞泳,张沙,杨华,周柔丽. LAPTM4B-35蛋白作为肝癌血清学诊断新标志物的探讨[J]. 北京大学学报(医学版), 2021, 53(4): 710-715. |
[13] | 肖若陶,刘承,徐楚潇,何为,马潞林. 术前血小板参数与局部进展期肾细胞癌预后[J]. 北京大学学报(医学版), 2021, 53(4): 647-652. |
[14] | 周广平,周倩云,朱继红. TAFRO综合征1例[J]. 北京大学学报(医学版), 2021, 53(4): 814-817. |
[15] | 白杲琛,宋毅,金杰,虞巍,何志嵩. 多西他赛联合卡铂治疗转移性去势抵抗性前列腺癌的临床疗效[J]. 北京大学学报(医学版), 2021, 53(4): 686-691. |
|