头颈部腺样囊性癌血行转移的临床研究  

Distant Metastasis in Adenoid Cystic Carcinoma of Head and Neck Origin

作　　者：冯平柏[1] 陆进成[1] 吴建峰[1] 

机构地区：[1]江苏省肿瘤医院,江苏南京210009

出　　处：《肿瘤防治杂志》2003年第2期165-168,共4页China Journal of Cancer Prevention and Treatment

摘　　要：目的 :观察头颈部腺样囊性癌远处转移情况、影响因素以及其对生存的影响。方法 :回顾性分析 5 1例头颈部腺样囊性癌的临床资料。结果 :远处转移率为 4 1 2 % (2 1 5 1) ;单部位和多部位远处转移分别占 71 4 % (15 2 1)和 2 8 6% (6 2 1) ;肺、骨、肝和脑的转移依次占 81 0 % (17 2 1)、2 3 8% (5 2 1)、14 3% (3 2 1)和 9 5 % (2 2 1)。远处转移的平均发生时间在首次治疗后 5 36年。远处转移组和未远处转移组的生存期、10年生存率分别为 9 81年和 14 31年 ,5 3 8%和 4 1 0 %。远处转移后平均生存期为 2 5 5年 ,2年生存率为 4 7 8%。单纯肺转移组与肺外转移组Log rank检验生存差异有显著性 (P =0 0 32 ) ,其平均生存期、2年生存率分别为 3 4 8年和 1 4 9年 ,72 7%和 2 0 0 %。分析结果还表明 ,远处转移率与患者的性别、年龄、病程长短以及侵犯解剖部位多少无关 ,但与首次手术是否规范 (P =0 0 2 5 )、术后综合治疗是否规范 (是否术后辅以放疗 ) (P =0 0 4 5 )以及是否局部复发 (P =0 0 4 3)相关。结论 :头颈部腺样囊性癌生存期长 ,远处转移率高 ,远处转移出现的时间较晚 ,出现远处转移后患者仍可长期生存。Objective To understand the incidence of distant metastasis (DM),the factors influencing DM and the survival for DM patients with adenoid cystic carcinoma of head and neck.Methods A retrospective clinical analysis was performed on 51 cases with adenoid cystic carcinoma of the head and neck.Results The overall DM rate was 41.2%(21/51).Among the overall DM,DM rates of one site,multi-site,lung,bone,liver and brain were 71.4%(15/21),28.6%(6/21),81.0%(17/21),23.8%(5/21),14.3%(3/21) and 9.5%(2/21),respectively.The mean time first seen DM after initial treatment was 5.36 years.The mean survival times and 10-year accumulative survival rates in the group DM and non-DM were 9.81 and 14.31 years,53.8% and 41.0%,respectively.The mean survival time and 2-year accumulative survival rate after DM were 2.55 years and 47.8%.There was significant difference (P=0.032) in survival rales between lung metastasis only and the metastasis rest.They were 72.7%and 20.0% respectively.Several DM impact factors were analyzed.There was no impact of the sex,age,history and anatomic invasion,but were impacts of radical recession at initial treatment (P=0.025),combination with postoperative radiotherapy (P=0.045) and local recurrence (P=0.043).Conclusions Adenoid cystic carcinoma of head and neck has a long time survival,high DM rate and prolonged DM appearance.The patients with DM can survive for a long time.Radical recession combined with postoperative radiotherapy at initial treatment probably can reduce its DM rate.

关 键 词：头颈部肿瘤 外科学 囊性癌 肿瘤转移 预后 生存 影响因素 

分 类 号：R739.91[医药卫生—肿瘤]