CAJ | 학술논문

目的分析小涎腺腺样囊性癌(adenoid cystic carcinoma,ACC)的预后及其影响因素,探讨合理治疗方法.方法回顾性分析52例ACC的临床资料,按照美国癌症联合委员会(American Joint Committee on Cancer,AJCC)临床分期标准Ⅰ期3例(6％)、Ⅱ期11例(21％)、Ⅲ期14例(27％),Ⅳ期24例(46％).计数资料采用x2检验或精确概率法,Kaplan-Meier法计算生存率、累积局部控制率和远处控制率,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 52例均手术治疗,39例(75％)接受术后放疗.治疗后区域复发率37％,远处转移率21％.5、10年累积局部控制率分别为68％和63％；5、10年累积远处控制率为86％和68％；5、10年肿瘤相关生存率分别为70％和54％.Cox多因素分析显示:T分期、淋巴结转移和神经侵犯与小涎腺ACC的肿瘤相关生存率有关(P＜0.05).结论小涎腺ACC治疗失败的主要原因是复发和转移.T分期、淋巴结转移和神经侵犯是其独立预后因素.根治性手术以及合理的术后放疗是治疗小涎腺ACC的主要方法.
목적 분석소연선선양낭성암(adenoid cystic carcinoma,ACC)적예후급기영향인소,탐토합리치료방법.방법 회고성분석52례ACC적림상자료,안조미국암증연합위원회(American Joint Committee on Cancer,AJCC)림상분기표준Ⅰ기3례(6％)、Ⅱ기11례(21％)、Ⅲ기14례(27％),Ⅳ기24례(46％).계수자료채용x2검험혹정학개솔법,Kaplan-Meier법계산생존솔、루적국부공제솔화원처공제솔,조간비교채용Log-rank대수질검험,Cox비례풍험모형진행다인소분석.결과 52례균수술치료,39례(75％)접수술후방료.치료후구역복발솔37％,원처전이솔21％.5、10년루적국부공제솔분별위68％화63％；5、10년루적원처공제솔위86％화68％；5、10년종류상관생존솔분별위70％화54％.Cox다인소분석현시:T분기、림파결전이화신경침범여소연선ACC적종류상관생존솔유관(P＜0.05).결론 소연선ACC치료실패적주요원인시복발화전이.T분기、림파결전이화신경침범시기독립예후인소.근치성수술이급합리적술후방료시치료소연선ACC적주요방법.
Objective To investigate the prognosis of adenoid cystic carcinoma (ACC) in minor salivary glands and its influencing factors.Methods Clinical data of 52 patients with ACC in minor salivary glands were reviewed.The distribution of stage was as follows:stage Ⅰ (6％),stage Ⅱ (21％),stageⅢ (27％) and stage Ⅳ(46％).Counting data was analyzed by x2 test or Fisher's exact.Survival rates were calculated by Kaplan-Merier method.Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test.Multivariate analysis was performed by Cox proportional hazard model.Results All patients underwent primary tumor radical resection,39 patients (75％) received postoperative radiation.The regional recurrence rate was 37％ and distant metastasis rate was 21％.The 5-,10-year cumulative local control rate were 68％ and 63％ respectively.The 5-,10-year cumulative distant control rate were 86％,68％ respectively.The 5-,10-year tumor specific survival rates were 70％ and 54％ respectively.Multivariate analysis showed that T stage,lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands.Conclusions Recurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands.T stage,lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands.Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.