涎腺分泌性癌27例临床分析  

Clinical analysis of 27 cases of secretory carcinoma of salivary gland

作　　者：高振杰 孙晶晶 高宁[1] 付坤[1] 徐卫靖 谢卫红[1] 何巍[1] GAO Zhenjie;SUN Jingjing;GAO Ning;FU Kun;XU Weijing;XIE Weihong;HE Wei(Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,郑州450052

出　　处：《郑州大学学报（医学版）》2021年第4期580-585,共6页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金青年基金项目(81901039)。

摘　　要：目的:探讨口腔颌面部涎腺分泌性癌(SCSG)的病理和临床表现,为SCSG的规范化诊疗提供参考。方法:回顾性分析2010年1月至2020年12月郑州大学第一附属医院收治的27例SCSG患者,分析其临床及病理特征、治疗方法及预后。结果:27例患者中,男15例,女12例,患者年龄10~69岁,病程3个月至20 a;发生于腮腺者21例,颌下腺2例,颊部2例,上腭及上唇各1例;均为分泌性癌,免疫组化结果显示S-100、Mammaglobin、CK7弥漫强阳性表达,Ki-67阳性率1%~50%;16例行ETS变异基因6(ETV6)基因断裂重组检测,结果均为阳性。27例全部行手术治疗,其中4例术后行放射性粒子植入术,3例行术后化疗,7例行术后放化疗;随访至2020年12月31日,局部复发8例、颈淋巴转移5例、远处转移2例、死亡1例。结论:SCSG最常见于腮腺,常呈良性病变形式;免疫组化及ETV6基因检测在诊断中有重要作用;治疗方式以手术为主,术后放射性粒子植入有助于改善其预后。Aim:To investigate the clinical manifestations and pathological changes of secretory carcinoma of salivary gland(SCSG),in order to provide reference for the standardized diagnosis and treatment of SCSG.Methods:A total of 27 SCSG patients from January 2010 to December 2020 in Department of Pathology of the First Affiliated Hospital,Zhengzhou University were enrolled,and the clinical and pathological characteristics,the clinical treatment and prognosis were analyzed.Results:Among the 27 cases,15 cases were male and 12 were female,the patients were at age of 10-69 years,and the course of disease were from 3 months to 20 years.Twenty-one cases occurred in parotid gland,2 cases in submandibular gland,2 cases in buccal,1 case in soft palate,and 1 case in upper lip.Pathological results were all SCSG,Immunohistochemicalresults showed that all cases were all strongly and diffusely positive for S-100,Mammaglobin,CK7,Ki-67 ranged from 1%~50%.ETV6 of 16 case were tested positive.All the 27 patients received surgical treatment,including 4 patients received postoperative radioactive particle implantation,3 patients received postoperative chemotherapy,and 7 patients received postoperative radiotherapy and chemotherapy.Follow up to December 31,2020,there were 8 cases of local recurrence,5 cases of cervical lymph node metastasis,2 cases of distant metastasis,and 1 case of death.Conclusion:SCSG is most common in the parotid gland and usually presents as a benign lesion.The diagnosis mainly depends on immunohistochemistry and ETV6 detection.The treatment is mainly operation.Postoperative radioactive particle implantation is helpful to improve the prognosis.

关 键 词：涎腺肿瘤 分泌性癌 ETS变异基因6 

分 类 号：R782[医药卫生—口腔医学]