涎腺淋巴上皮癌16例临床分析  

Clinical Analysis of Sixteen Cases of Lymphoepithelial Carcinoma of Salivary Gland

作　　者：张诠[1,2] 卿菁[1,2] 魏茂文[1,2] 郭朱明[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室 [2]中山大学肿瘤防治中心头颈科,广东广州510060

出　　处：《癌症》2005年第11期1384-1387,共4页Chinese Journal of Cancer

摘　　要：背景与目的:涎腺淋巴上皮癌是一种少见的特殊类型的恶性肿瘤,有关该病的的单独报道甚少。本文拟对在我院治疗的涎腺淋巴上皮癌病例的临床特点、治疗及疗效作一总结分析。方法:回顾性分析1990年1月至2004年9月在我院经过病理确诊和治疗的涎腺淋巴上皮癌患者共16例的临床资料,应用Kaplan-Meier法进行生存分析。结果:16例涎腺淋巴上皮癌占我院同期涎腺恶性肿瘤的3.6%(16/443)。所有患者均为单侧腺体发病,发病年龄为15～57岁,男女比例为1∶1,本组患者均来自中国南方。除1例患者未行EB病毒血清学检查以外,其余患者EB病毒血清学检查示EBV-VCA-IgA阳性率为93.3%(14/15),EBV-EA-IgA阳性率为66.7%(10/15),EBV-DNA酶阳性率为86.7%(13/15)。16例患者均接受手术治疗,其中单纯手术治疗9例,手术+术后放疗5例,手术+术后放、化疗1例,手术+化疗1例。术后病理证实4例有同侧颈淋巴结转移者,转移率为25%(4/16)。1、3、5年生存率分别约为86.15%、48.46%、24.23%。结论:涎腺淋巴上皮癌分化差,但预后较好,在治疗上宜应采取彻底手术切除加术后辅助放疗。BACKGROUND ＆ OBJECTIVE. Lymphoepithelial carcinoma of salivary gland is a rare and special kind of malignant tumor, and has seldom been reported. This study was to summarize the clinical features, treatment and curative effect of this disease according to our experiences. METHODS. Clinical data of 16 patients with pathologically confirmed primary lymphoepithelial carcinoma of salivary gland, treated in Cancer Center of Sun Yat-sen University from Jan. 1990 to Sep. 2004, were retrospectively analyzed, and survival analysis was performed with Kaplan-Meier method. RESULTS. The 16 patients with lymphoepithelial carcinoma of salivary gland accounted for 3.6% of all the patients diagnosed as malignant tumors of salivary gland simultaneously in our center. All patients had tumors occurred in unilateral gland, aged 15-57 years, with the female to male ratio of 1：1. All patients were from southern China. Except for 1 patient, the rest 15 had Epstern-Barr virus （EBV） serological tests. The positive rates of EBV-VCA- IgA, EBV-EA-IgA, and EBV-DNA enzyme were 93.3%, 66.7%, and 86.7%, respectively. All patients were treated with surgery, of which 9 received surgery only, 5 received surgery plus postoperative radiotherapy, 1 received surgery plus postoperative chemoradiotherapy, 1 received surgery plus chemotherapy. Four （25.0%） patients had postoperative pathology-proved ipsilateral cervical lymph node metastasis. The 1-, 3-, and 5-year survival rates of the 16 patients were 86.15% , 48.46% , and 24.23%. CONCLUSIONS. Although lymphoepithelial carcinoma of salivary gland is poorly differentiated, the prognosis of this disease is good. Complete resection plus postoperative radiotherapy is possibly accommodating.

关 键 词：涎腺肿瘤 淋巴上皮 EB病毒 血清学检测 外科手术 放射治疗 临床分析 

分 类 号：R739.8[医药卫生—肿瘤]