76例大涎腺粘液表皮样癌长期随访结果及预后分析  

Long-term Follow-up Results and Prognosis Analysis of 76 Cases of Mucoepidermoid Carcinoma from Major Salivary Gland

作　　者：邓丽霞 廖文军 张石川 樊晋川 Deng Lixia;Liao Wenjun;Zhang Shichuan;Fan Jinchuan(Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China;Sichuan Cancer Hospital ＆ Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, Sichuan , China)

机构地区：[1]西南医科大学附属医院肿瘤科,四川泸州646000 [2]四川省肿瘤医院·研究所,四川省癌症防治中心电子科技大学医学院,成都610041

出　　处：《肿瘤预防与治疗》2018年第3期183-188,共6页Journal of Cancer Control And Treatment

摘　　要：目的:回顾大涎腺来源粘液表皮样癌(mucoepidermoid carcinoma,MEC)患者治疗效果,评价其影响因素。方法:收集近10年在四川省肿瘤医院初治的大涎腺MEC患者临床资料,回顾性分析影响大涎腺MEC患者预后的临床因素。结果:2006年2月至2017年2月间,四川省肿瘤医院共收治大涎腺MEC 90例,排除病理及随访资料不完整14例,最终76例大涎腺MEC纳入研究。患者总体5年无疾病生存率(disease-free survival,DFS)为84.0%,5年总生存率(overall survival,OS)为94.0%。多因素分析显示淋巴结转移是影响大涎腺MEC患者无疾病生存的独立预后因素,病理分级既是影响患者无疾病生存,也是影响总生存的独立预后因素。在63例腮腺来源的MEC患者中,以无疾病生存为临床终点,腮腺深浅叶全切除是独立于病理分级的重要预后因子。结论:接受以手术为主的综合规范治疗后,大涎腺MEC患者的预后较好。病理分级是影响大涎腺MEC患者无疾病生存和总生存的独立预后因素。腮腺腺体全切较部分切除有助于提高腮腺MEC肿瘤控制率。Objective： To study the clinical outcomes of patients with mucoepidermoid carcinoma（ MEC） originated from major salivary gland and to evaluate the related prognostic factors. Methods： We reviewed the medical records of MEC from major salivary gland treated in Sichuan Cancer Hospital in past decade. The possible relationships between clinical factors and prognosis were retrospectively analyzed. Results： From February 2006 to February 2017,a total of 90 patients with major salivary gland MEC were treated in Sichuan Cancer Hospital. 14 patients were excluded because of incomplete pathological and clinical records. 76 patients were finally included in this study. The 5-year disease free survival（ DFS） rate was 84. 0%,and 5-year overall survival（ OS） rate was 94. 0%. Multivariate analysis revealed that lymph node metastases was an independent prognostic factor for DFS,pathological grade was an independent prognostic factor for both OS and DFS. For the 63 parotid MEC,total parotidectomy was an independent predictor from pathological grade for DFS. Conclusion： MEC from major salivary gland has relatively good prognosis after receiving surgery-based combined therapy. Pathological grade is an independent factor that correlated with both OS and DFS. Total parotidectomy is superior to partial parotidectomy in disease control for parotid MEC.

关 键 词：大涎腺 粘液表皮样癌 手术 预后因素 

分 类 号：R739.87[医药卫生—肿瘤] R730.7[医药卫生—临床医学]