唾液腺透明细胞癌的诊断与治疗  

Diagnosis and treatment of clear cell carcinoma of salivary gland

作　　者：王强[1] 沈毅[2] 孙坚[2] 

机构地区：[1]沈阳医学院附属奉天医院口腔科,辽宁沈阳110024 [2]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科,上海200011

出　　处：《中国口腔颌面外科杂志》2008年第4期266-269,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨唾液腺透明细胞癌的诊断和治疗原则。方法:2002年8月-2007年1月间共收治唾液腺透明细胞癌11例,均行手术扩大切除。3例有颌骨破坏者,分别行上颌骨次全切除、双侧上颌骨部分切除和下颌骨节段性切除,5例颈淋巴结肿大者行颈淋巴清扫术,对术后软硬组织缺损采用不同方法修复,5例辅以术后放疗。结果:11例术后病理均为唾液腺透明细胞癌,4例颈淋巴结转移。透明细胞免疫组化CK均(+),S-100均(-),9例SMA(-)。除1例前臂皮瓣部分坏死外,11例伤口均愈合良好,无其他并发症。所有患者术后已随访0.5～5a,未发现局部肿瘤复发、颈淋巴结和远处转移。结论:唾液腺透明细胞癌是一种少见的唾液腺低度恶性肿瘤,免疫组化检查有助于确诊治疗首选局部广泛切除,颈淋巴结转移者应行颈淋巴清扫术,术后放疗主要用于局部复发或颈淋巴结转移者,患者一般预后良好。PURPOSE： To explore the diagnosis and treatment principles of clear cell carcinoma of salivary gland （CCCSG）. METHODS： From August 2002 to January 2007, eleven patients with CCCSG were treated by wide surgical resection. Three patients with jaw bone involved individually underwent subtotal maxillectomy, bilateral partial maxillectomy and segmental mandibulectomy.Five patients with neck lymph node metastases were treated with neck dissection. The soft and hard tissue defects after resection were reconstructed with different methods. Postoperative radiotherapy was performed in 5 patients. RESULTS： Postoperative pathological diagnosis of all patients was CCCSG, cervical lymph node metastasis were confirmed in 4 patients. Immunohistochemically of clear cells were all positive for CK and negative for S-100,were negative for SMA in 9 patients. The wound healing was good without and complications in 10 patients and one forearm flap in one patient had partial necrosis. During the postoperative follow-up period form 6 months to 5 years, recurrences, cervical lymph node or distant metastasis was not found in all patients. CONCLUSIONS： CCCSG is a rare salivary gland low-grade malignant neoplasm. Immunohistochemistry can be used to confirm the diagnosis. Wide resection is the treatment of first choice, neck dissection should be done in patient with neck lymph node metastasis. Post-operative radiotherapy is used mainly for loco-regional recurrence and neck lymph node metastasis. The patient＇s prognosis is usually good.

关 键 词：唾液腺 透明细胞癌 诊断 治疗 

分 类 号：R739.8[医药卫生—肿瘤]