摘要
目的:本研究旨在回顾性分析头颈部腺样囊性癌的颈部淋巴结的临床转移规律。方法:回顾性分析1995年1月至2008年12月就诊于上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科的616例腺样囊性癌患者的临床资料,对其中62例腺样囊性癌合并颈部淋巴结转移的患者进行临床统计学分析。结果:头颈部腺样囊性癌的颈淋巴结转移的发生率约为10%,原发于舌根、舌体及口底部的腺样囊性癌较其他部位更易发生颈部淋巴结转移,分别为19.2%、17.6%和15.3%,转移部位多发生在Ⅰb区与Ⅱ区。淋巴结转移的方式以经典的管道性转移为主,直接浸润型转移仅常见于下颌下腺的腺样囊性癌累及颌下淋巴结。原发部位及瘤周淋巴血管浸润与颈部淋巴结转移的发生密切相关。出现颈部淋巴结转移的患者其临床预后明显较差(P<0.01)。结论:舌-口底复合体为头颈部腺样囊性癌发生淋巴结转移的常见原发部位,在临床治疗及随访上应得到更多关注。
Objective： Adenoid cystic carcinoma （ACC） is an uncommon malignant neoplasm, which mostly originates from the major and minor salivary glands of the head and neck region. This study aims to provide new information on head and neck ACC with cervical lymph node metastasis. Methods： Out of the 616 patients who underwent primary tumor resection from 1995 to 2008 in the authors＇ hospital, 62 cases with cervical lymph node metastasis were analyzed. Results： The general incidence rate of cervical lymph node me- tastasis in ACC was approximately 10%. The base of the tongue, mobile tongue, and mouth floor were the most frequent sites of lymph node metastasis with incidence rates of 19.2%, 17.6%, and 15.3%, respectively. Most cases exhibited the classic ＂tunnel-style＂ metastatic pattern of occurrence, and the level Ⅰ b and Ⅱ regions were the most frequently involved areas. Primary site and lympho- vascular invasions were significantly associated with lymph node metastasis. High patient mortality rate was also significantly correlated with a high number of lymph node positive cases. Conclusion： Cervical lymph node metastasis has a high tendency of occurrence in the tongue-mouth floor complex, following the classic ＂tunnel-style＂ metastatic pattern. Peritumoral lymphovascular invasion could be taken as a strong predictor for the occurrence of lymph node metastasis, which ultimately leads to poor prognosis of ACC patients. A selective neck dissection should be considered as a management in such patients.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2016年第24期1094-1098,共5页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金项目(编号:81102049,81472517)
上海市浦江人才计划项目(编号:15PJD024)
上海交通大学晨星学者计划和上海高校高峰高原学科(口腔医学)建设项目资助~~
关键词
唾液腺
腺样囊性癌
淋巴结转移
预后
salivary gland, adenoid cystic carcinoma, cervical lymph node metastasis, prognosis
