摘要
目的分析小涎腺腺样囊性癌（adenoid cystic carcinoma，ACC）的预后及其影响因素，探讨合理治疗方法。方法回顾性分析52例ACC的临床资料，按照美国癌症联合委员会（American Joint Committee on Cancer，AJCC）临床分期标准Ⅰ期3例（6％）、Ⅱ期11例（210k）、Ⅲ期14例（27％），Ⅳ期24例（46％）。计数资料采用）（2检验或精确概率法，Kaplan—Meier法计算生存率、累积局部控制率和远处控制率，组间比较采用Log—rank对数秩检验，Cox比例风险模型进行多因素分析。结果52例均手术治疗，39例（75％）接受术后放疗。治疗后区域复发率37％，远处转移率21％。5、10年累积局部控制率分别为68％和630k；5、10年累积远处控制率为86％和68％；5、10年肿瘤相关生存率分别为70％和54％。Cox多因素分析显示：T分期、淋巴结转移和神经侵犯与小涎腺ACC的肿瘤相关生存率有关（P〈0．05）。结论小涎腺ACC治疗失败的主要原因是复发和转移。T分期、淋巴结转移和神经侵犯是其独立预后因素。根治性手术以及合理的术后放疗是治疗小涎腺ACC的主要方法。
[ Abstract] Objective To investigate the prognosis of adenoid cystic carcinoma （ACC） in minor salivary glands and its influencing factors. Methods Clinical data of 52 patients with ACC in minor salivary glands were reviewed. The distribution of stage was as follows： stage I （6%）, stage ]I （21%）, stagelU （27%） and stage 1V（46% ）. Counting data was analyzed by ~2 test or Fisher＇s exact. Survival rates were calculated by Kaplan-Merier method. Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model. Results All patients underwent primary tumor radical resection, 39 patients （75%） received postoperative radiation. The regional recurrence rate was 37% and distant metastasis rate was 21%. The 5-, 10-year cumulative local control rate were 68% and 63% respectively. The 5-, 10-year cumulative distant control rate were 86% ,68% respectively. The 5-, 10-year tumor specific survival rates were 70% and 54% respectively. Multivariate analysis showed that T stage, lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands. Conclusions Recurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands. T stage, lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands. Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2012年第12期705-710,共6页
Chinese Journal of Stomatology
关键词
涎腺肿瘤
腺样囊性癌
预后
Salivary gland neoplasms
Adenoid cystic carcinoma
Prognosis
