摘要
背景与目的:涎腺腺样囊性癌是一类恶性程度高的涎腺肿瘤,针对大涎腺来源的腺样囊性癌的研究较少。本研究旨在探讨影响大涎腺腺样囊性癌患者预后的因素。方法:回顾性分析1971年1月至1998年7月中山大学肿瘤防治中心收治并随诊7年以上的64例大涎腺腺样囊性癌患者的临床资料,应用Kaplan-Meier法进行生存分析,组间比较用log-rank检验,多因素分析采用Cox模型进行分析,两组比率的比较采用χ2检验。结果:本组总死亡率为57.8%,肿瘤相关死亡率为46.9%;5年、10年累积生存率分别为65.6%和54.5%;复发率为34.4%,远处转移率为45.0%;单因素分析结果显示,年龄、神经是否受侵、病理类型、临床分期、手术切缘是否干净是影响患者预后的因素。年龄≥50岁、神经受侵、病理类型为实体型或小管型、临床分期为晚期(Ⅲ、Ⅳ期)、切缘阳性者的预后较年龄<50岁、神经未受侵、病理类型为筛孔状、临床分期为早期(Ⅰ、Ⅱ期)、切缘阴性者差;多因素分析结果显示,神经受侵、病理类型为实体型、临床分期属于晚期(Ⅲ、Ⅳ期)、切缘阳性者,预后差。结论:神经是否受侵、病理类型、临床分期、手术切缘是否干净是影响大涎腺腺样囊性癌患者预后的独立因素。
BACKGROUND ＆ OBJECTIVE： Adenoid cystic carcinoma of salivary glands is a kind of highly malignant tumor, and researches on the tumors originated from major salivary glands are rare. This study was to investigate prognostic factors of adenoid cystic carcinoma of major salivary glands. METHODS： Clinical records of 64 patients with adenoid cystic carcinoma of major salivary glands followed up for more than 7 years were reviewed. Cumulative survival rate was analyzed by the Kaplan-Meier method. The log-rank test was applied to compare survival rates, and the comparison of the percentage of subjects between two groups was conducted with X^2 test. RESULTS： The overall death rate was 57.8%; the cause-specific death rate was 46.9%; the 5- and 10-year cumulative survival rates were 65.63% and 54.52%, respectively; the relapse rate was 34.4%; and the metastasis rate was 45%. Univariate analysis revealed that the factors impacting the prognosis were age, presence or absence of nerve invasion, histological subtypes, clinical stage, positive or negative surgical margin. Patients aged ≥ 50, presence of nerve invasion, solid/tubular subtype, advanced clinical stage （stages Ⅲ and Ⅳ）, and positive surgical margin had poorer prognosis than those aged 〈 50, absence of nerve invasion, cribriform subtype, early clinical stage （stages Ⅰ and Ⅱ ）, and negative surgical margin. Multivariate analysis showed that the presence of nerve invasion, solid histological subtype, advanced clinical stage （stages Ⅲ and Ⅳ）, and positive surgical margin were independently associated to poor prognosis. CONCLUSION： Presence or absence of nerve invasion, histological subtype, clinical stage, and positive or negative surgical margin are the independent factors affecting the prognosis of patients with adenoid cystic carcinoma of salivary glands.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2006年第9期1138-1143,共6页
Chinese Journal of Cancer
关键词
涎腺肿瘤
大涎腺腺样囊性癌
预后
累积生存率
多因素分析
Salivary glands neoplasm
Adenoid cystic carcinoma of major salivary glands
Prognosis
Cumulative survival rate
Multivariate analysis
