中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2012年
3期
202-206
,共5页
葛明华%王佳峰%夏庆民%谭卓%徐加杰%陈超%王可敬%谭向荣
葛明華%王佳峰%夏慶民%譚卓%徐加傑%陳超%王可敬%譚嚮榮
갈명화%왕가봉%하경민%담탁%서가걸%진초%왕가경%담향영
涎腺肿瘤%癌,腺样囊性%放射疗法%预后
涎腺腫瘤%癌,腺樣囊性%放射療法%預後
연선종류%암,선양낭성%방사요법%예후
Salivary gland neoplasms%Carcinoma,adenoid cystic%Radiotherapy%Prognosis
目的 分析涎腺腺样囊性癌的预后并探讨其影响因素.方法 回顾性分析76例涎腺腺样囊性癌的临床资料.大涎腺来源27例(35.5％),小涎腺来源49例(64.5％).Ⅰ期8例(10.5％),Ⅱ期23例(30.3％),Ⅲ期18例(23.7％),Ⅳ期27例(35.5％).计数资料采用x2检验或精确概率法,Kaplan-Meier法计算生存率,组间比较采用Log-rank对数秩检验,Cox比例风险模型进行多因素分析.结果 全组病例区域复发率28.9％,远处转移率21.0％.5年、10年总体生存率分别为73.7％、48.2％；5年、10年无瘤生存率分别为61.8％、39.8％；5年、10年肿瘤相关生存率为74.9％、56.2％.单因素分析结果显示,病理类型、肿瘤分期和周围神经侵犯对涎腺腺样囊性癌生存率的影响有统计学意义(P值均＜0.05).Cox模型多变量分析显示,病理类型、肿瘤分期及周围神经侵犯是影响涎腺腺样囊性癌患者预后的独立危险因素(P值均＜0.05).对于Ⅲ、Ⅳ期患者,放疗组的无瘤生存率与未放疗组相比有升高趋势,但差异无统计学意义(P=0.052).结论TNM分期、病理类型和周围神经侵犯是影响涎腺腺样囊性癌预后的独立危险因素,手术是治疗腺样囊性癌的主要方法,术后放疗可能提高Ⅲ、Ⅳ期患者的无瘤生存时间.
目的 分析涎腺腺樣囊性癌的預後併探討其影響因素.方法 迴顧性分析76例涎腺腺樣囊性癌的臨床資料.大涎腺來源27例(35.5％),小涎腺來源49例(64.5％).Ⅰ期8例(10.5％),Ⅱ期23例(30.3％),Ⅲ期18例(23.7％),Ⅳ期27例(35.5％).計數資料採用x2檢驗或精確概率法,Kaplan-Meier法計算生存率,組間比較採用Log-rank對數秩檢驗,Cox比例風險模型進行多因素分析.結果 全組病例區域複髮率28.9％,遠處轉移率21.0％.5年、10年總體生存率分彆為73.7％、48.2％；5年、10年無瘤生存率分彆為61.8％、39.8％；5年、10年腫瘤相關生存率為74.9％、56.2％.單因素分析結果顯示,病理類型、腫瘤分期和週圍神經侵犯對涎腺腺樣囊性癌生存率的影響有統計學意義(P值均＜0.05).Cox模型多變量分析顯示,病理類型、腫瘤分期及週圍神經侵犯是影響涎腺腺樣囊性癌患者預後的獨立危險因素(P值均＜0.05).對于Ⅲ、Ⅳ期患者,放療組的無瘤生存率與未放療組相比有升高趨勢,但差異無統計學意義(P=0.052).結論TNM分期、病理類型和週圍神經侵犯是影響涎腺腺樣囊性癌預後的獨立危險因素,手術是治療腺樣囊性癌的主要方法,術後放療可能提高Ⅲ、Ⅳ期患者的無瘤生存時間.
목적 분석연선선양낭성암적예후병탐토기영향인소.방법 회고성분석76례연선선양낭성암적림상자료.대연선래원27례(35.5％),소연선래원49례(64.5％).Ⅰ기8례(10.5％),Ⅱ기23례(30.3％),Ⅲ기18례(23.7％),Ⅳ기27례(35.5％).계수자료채용x2검험혹정학개솔법,Kaplan-Meier법계산생존솔,조간비교채용Log-rank대수질검험,Cox비례풍험모형진행다인소분석.결과 전조병례구역복발솔28.9％,원처전이솔21.0％.5년、10년총체생존솔분별위73.7％、48.2％；5년、10년무류생존솔분별위61.8％、39.8％；5년、10년종류상관생존솔위74.9％、56.2％.단인소분석결과현시,병리류형、종류분기화주위신경침범대연선선양낭성암생존솔적영향유통계학의의(P치균＜0.05).Cox모형다변량분석현시,병리류형、종류분기급주위신경침범시영향연선선양낭성암환자예후적독립위험인소(P치균＜0.05).대우Ⅲ、Ⅳ기환자,방료조적무류생존솔여미방료조상비유승고추세,단차이무통계학의의(P=0.052).결론TNM분기、병리류형화주위신경침범시영향연선선양낭성암예후적독립위험인소,수술시치료선양낭성암적주요방법,술후방료가능제고Ⅲ、Ⅳ기환자적무류생존시간.
Objective To investigate the prognosis of adenoid cystic carcinoma (ACC) in salivary gland and its influencing factors.Methods Clinical and following-up data of 76 patients with ACC in salivary glands were reviewed. Major gland tumors represented 35.5％ whereas minor gland tumors comprised 64.5％ of the cohort,with 8 cases ( 10.5％ ) in stage I,23 (30.3％ ) in stage Ⅱ,18 (23.7％) in stage Ⅲ and 27 (35.5％) in stage Ⅳ. Survival rates were calculated by Kaplan-Merier method.Cumulative survival curves were evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.Results The regional recurrence rate was 28.9％ and distant metastasis rate was 21.1％.The overall 5-year survival rate,tumor-free survival rate and tumor-related survival rate were 73.7％,61.8％ and 74.9％ respectively.The overall 10-year survival rate,tumor-free survival rate and tumor-related survival rate were 48.2％,39.8％ and 56.2％ respectively.Univariate survival analysis showed pathological type,clinical stage and perineural invasion were relevant to the prognosis of ACC and multivariate analysis showed they were the independent prognostic factors of ACC in salivary gland.Conclusions Clinical stage,pathological type and perineural invasion were the independent prognostic factors for adenoid cystic carcinoma in salivary gland. Surgery was the first choice for the treatment of adenoid cystic carcinoma in salivary gland,and postoperative radiotherapy may prolong the tumor-free survival time of patients in stage Ⅲ and Ⅳ.
