摘要
目的探讨涎腺淋巴上皮癌的临床特征、治疗方式和预后情况,为其临床治疗提供相关经验。方法回顾性收集2012年1月至2025年5月上海长海医院收治的20例涎腺淋巴上皮癌患者,分析其临床特征、影像学表现、治疗方式和生存时间等资料。结果20例患者中男14例,女6例;年龄19~69岁,平均(50.9±15.5)岁;原发于腮腺者16例,原发于颌下腺者4例;美国癌症联合委员会(AJCC)分期Ⅰ~Ⅱ期者11例,Ⅲ~Ⅳ期者9例;5年总体生存率为95%(19/20);5年累积复发转移率为30%(6/20),其中Ⅲ、Ⅳ期患者5例,Ⅱ期患者1例。远期观察发现淋巴结转移和AJCC分期Ⅲ~Ⅳ期是复发转移的危险因素。死亡病例均为晚期患者,死亡原因为局部复发及远处转移。结论涎腺淋巴上皮癌发病率较低,且易发生颈部淋巴结转移。AJCC分期Ⅲ~Ⅳ期和确诊时存在淋巴结转移是疾病复发转移的危险因素。对于早期患者,手术+术后放疗可取得满意的疗效;对于中晚期及复发转移的患者,手术+术后放化疗为必要的常规手段,应用靶向及免疫治疗可能有助于控制病情。该病总体预后较好,但仍需定期复诊。
Objective To investigate the clinical characteristics,treatment modalities,and prognosis of lymphoepithelial carcinoma(LEC)of the salivary gland,providing relevant clinical experience.Method Clinical data from 20 patients with salivary gland LEC were collected and analyzed,including clinical manifestations,imaging fi ndings,treatment approaches,and survival time.Result Among the 20 patients,14 were male and 6 were female,with a mean age of 50.9±15.5 years.The tumor originated in the parotid gland in 16 cases and in the submandibular gland in 4 cases.According to the AJCC cancer staging system,11 patients were stageⅠ-Ⅱand 9 were stageⅢ-Ⅳ.The 5-year overall survival rate was 95%.The 5-year recurrence or metastasis rate was 30%,with stageⅢ-Ⅳpatients accounting for 25%and stageⅡpatients for 5%.Long-term observation identifi ed lymph node metastasis and advanced tumor stage(Ⅲ-Ⅳ)as risk factors for recurrence and metastasis.All fatalities occurred in advanced-stage patients,with causes of death being local recurrence and distant metastasis.Conclusion Salivary gland LEC has a low incidence and is prone to cervical lymph node metastasis.Patients in stagesⅢandⅣ,as well as those with lymph node metastasis are at risk for disease recurrence and metastasis.For early-stage patients,surgery plus postoperative radiotherapy achieves satisfactory outcomes.For patients with locally advanced,recurrent,or metastatic disease,surgery followed by postoperative chemoradiotherapy is a conventional and necessary approach,while the application of targeted immunotherapy may help control the disease.Overall prognosis is favorable,regular follow-up remains essential.
作者
丁同慧
陈鸿远
宋健洁
郑宏良
朱敏辉
朱乘婧
王伟
Ding Tonghui;Chen Hongyuan;Song Jianjie;Zheng Hongliang;Zhu Minhui;Zhu Chengjing;Wang Wei(Department of Otorhinolaryngology,Changhai Hospital,Shanghai 200433,China;Department of Pathology,Changhai Hospital,Shanghai,200433,China)
出处
《中国医刊》
2026年第2期204-210,共7页
Chinese Journal of Medicine
基金
国家自然科学基金(82571297)。
关键词
淋巴上皮癌
涎腺
颈淋巴结清扫
EB病毒
Lymphoepithelial carcinoma
Salivary gland
Neck dissection
Epstein-Barr virus(EBV)
