CAJ | 학술논문

目的探讨涎腺导管癌的临床生物学特征、治疗及预后.方法回顾性分析1995年4月至2006年10月行根治手术治疗的12例涎腺导管癌的临床生物学特征、影像学特点、病理、治疗及预后资料.结果 12例涎腺导管癌患者中男女之比为5:1,发病年龄53～73岁,中位年龄为56岁;临床上表现为质硬、界限不清肿块,常伴有神经侵犯症状;病理学特征是导管样细胞巢呈实质性、筛孔状和乳头状结构,中心可出现粉刺样坏死;手术切除+颈淋巴清扫者11例,术后辅以放疗10例,辅以化疗者3例.12例均获随访,随访时间7～65个月,平均随访时间(31±21)个月.生存期满1年者10例,满3年者5例,满5年者仅3例,中位生存时间约为36个月.结论涎腺导管癌是一类较少见但恶性度很高的涎腺恶性肿瘤,好发于中老年男性;治疗以局部广泛切除+颈淋巴结清除为主,可辅以放疗或化疗;本病易出现同侧颈部Ⅰ、Ⅱ、Ⅲ区淋巴结转移,预后较差.
목적 탐토연선도관암적림상생물학특정、치료급예후.방법 회고성분석1995년4월지2006년10월행근치수술치료적12례연선도관암적림상생물학특정、영상학특점、병리、치료급예후자료.결과 12례연선도관암환자중남녀지비위5:1,발병년령53～73세,중위년령위56세;림상상표현위질경、계한불청종괴,상반유신경침범증상;병이학특정시도관양세포소정실질성、사공상화유두상결구,중심가출현분자양배사;수술절제+경림파청소자11례,술후보이방료10례,보이화료자3례.12례균획수방,수방시간7～65개월,평균수방시간(31±21)개월.생존기만1년자10례,만3년자5례,만5년자부3례,중위생존시간약위36개월.결론 연선도관암시일류교소견단악성도흔고적연선악성종류,호발우중노년남성;치료이국부엄범절제+경림파결청제위주,가보이방료혹화료;본병역출현동측경부Ⅰ、Ⅱ、Ⅲ구림파결전이,예후교차.
Objective To explore the clinico-biological characteristics, treatment and prognosis of salivary duct carcinoma. Methods This study included 12 cases of salivary duct carcinoma treated in our hospital. Clinical data were retrospectively analyzed for patients admitted between April 1995 and October 2006. The clinical characteristics, histological features, imaging, therapy methods and prognosis were analyzed. Results Of 12 salivary duct carcinoma, there were 10 males, 2 females. The age of onset ranged from 53 to 73 year old and the average was 56 year old. Physical examination revealed a firm and unboundary mass accompanied by nerve infiltrating symptom. The histological appearance was characterized by solid cell nests with ductal structures and central comedonecrosis. Extensive resection and radical neck dissection was performed in 11 patients, postoperation radiation done in 10 patients and chemotherapy in 3 patients. One year survival rate was 83. 33% , that of 3 years was 41. 67% , and of 5 years was 25. 00% , the median survival time was 36 months. Conclusion Salivary duct carcinoma is a rare malignant salivary tumor and most patients are men. Regional extensive resection and postoperative radiation or chemotherapy are the mainstay of therapy. Lymph node metastases in level Ⅰ ,Ⅱ , Ⅲ are a common finding in patients with SDC and the prognosis is poor.