腮腺多形性腺瘤恶变52例临床病理分析及随访  

Clinicopathological analysis and follow-up of 52 cases of malignant transformation of pleomorphic adenoma of the parotid gland

作　　者：毕文婷 魏博[2] 孙惠[2] 葛柳花[2] 胡敏[2] 刘华蔚[2] BI Wenting;WEI Bo;SUN Hui;GE Liuhua;HU Min;LIU Huawei(Department of stomatology,Beijing Hospital of Integrated Chinese and Western Medicine,Beijing 100089)

机构地区：[1]北京中西医结合医院口腔科,100089 [2]解放军总医院第一医学中心口腔科

出　　处：《现代口腔医学杂志》2024年第6期414-418,共5页Journal of Modern Stomatology

基　　金：国家自然青年基金项目(81901023)。

摘　　要：目的研究腮腺多形性腺瘤恶变的临床病理特点、治疗结果及预后影响因素。方法回顾分析某医院口腔颌面外科2008年4月至2015年4月间52例腮腺多形性腺瘤恶变的病理与临床资料,记录所有病例的初诊时间、复发次数、手术次数及随访结果等指标,并进行各参数生存分析比较。结果52例腮腺多形性腺瘤恶变病例,男34例,女18例,男女比为1.89∶1,50~59岁最好发(15例),单纯手术组五年生存率85%,手术+放疗组五年生存率75%,两组无统计学差异(P>0.05)。病程>10年达22例,五年生存率67.6%,病程≤10年者五年生存率90%,两组患者生存情况有统计学差异(P<0.05)。初次手术患者五年生存率100%,手术2次患者五年生存率73.2%,手术3次及以上患者五年生存率61.5%,初次手术组与手术3次及以上组差异有统计学意义(P<0.05)。结论腮腺多形性腺瘤恶变多见于中老年男性,病程10年以上,复发3次及以上,恶变的几率高且预后相对较差。单纯手术组与手术+放疗组都有较高的生存率。Objective This study aims to investigate the clinicopathological characteristics,treatment outcomes,and prognostic factors associated with the malignant transformation of pleomorphic adenoma of the parotid gland.Methods A retrospective analysis of clinicopathological records from April 2008 to April 2015 was conducted,including 52 cases of malignant transformation of pleomorphic adenoma of the parotia gland treated in the Department of Oral and Maxillofacial Surgery.The analysis involved collecting data on initial diagnosis dates,recurrences,surgical interventions,and follow-up outcomes to conduct survival analysis and identify prognostic factors.Results The cohort consisted of 34 male and 18 female patients,with a male-to-female ratio of 1.89:1.The age group most affected was 50 to 59 years(15 cases).While the five-year survival rate stood at 85%for patients undergoing only surgery,it was slightly lower at 75%for those receiving combined surgical and radiotherapy treatment,although this difference was not statistically significant(P>0.05).Notably,a marked statistical significance was observed in the five-year survival rates between patients with a disease duration exceeding ten years(67.6%)and those with a shorter disease duration(90%)(P<0.05).The fiveyear survival rate for patients undergoing a single surgical procedure was 100%,decreasing to 73.2%for those undergoing two surgeries and further to 61.5%for patients requiring three or more surgeries,with significant statistical differences noted between patients undergoing a single surgery and those undergoing three or more surgeries(P<0.05).Conclusion Malignant transformation of pleomorphic adenoma of the parotid gland is predominantly observed in middle-aged and elderly males.The chance of malignant transformation is high and the prognosis is relatively poor in cases with a disease duration of more than 10 years and three or more recurrences.Both the group undergoing surgery alone and the group receiving surgery combined with radiotherapy exhibit relatively hig

关 键 词：腮腺 多形性腺瘤 复发 恶变 

分 类 号：R739.8[医药卫生—肿瘤]