涎腺腺样囊性癌66例临床分析(1)
摘要：目的 探讨涎腺腺样囊性癌部位、分期、治疗方法与复发及转移关系。方法 对66例涎腺腺样囊性癌患者的病历资料作临床分析。结果 腮腺23例，舌下腺14例，颌下腺6例，腭部12例，颊部8例，舌根3例。治疗方法，腮腺腺腺样囊性癌行全腮腺摘除13例，腮腺浅叶+部分深叶摘除9例，腮腺浅叶摘除1例；保留面神经18例，面神经切除5例；行肩胛舌骨上淋巴清扫15例。颌下腺、舌下腺、颊部、舌根腺样囊性癌均行腺体及局部扩大切除+同侧肩胛舌骨上淋巴清扫术；腭部腺腺样囊性癌行局部扩大切除+同侧肩胛舌骨上淋巴清扫术6例，单纯行局部扩大切除2例；术后放疗60例，同时行术后放化疗3例。术后复查3～10年，局部复发8例，远处转移9例。临床分期，Ⅰ期10例、Ⅱ42期例、Ⅲ期8例、Ⅳ期6例。结论 颌下腺、舌下腺、颊部、舌根、腭部腺样囊性癌应同期行局部扩大切除+同侧肩胛舌骨上淋巴清扫术；腮腺腺腺样囊性癌如无神经受损症状及术中肿物与神经无明显粘连可保留面神经，术前检查如淋巴结无明显肿大可不作颈淋巴清扫术。术后均应行放疗。术后化疗效果如何本组病例不明确。Ⅲ、Ⅳ期较Ⅰ、Ⅱ期复发、转移为高。
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关键词：涎腺腺样；囊性癌；手术放疗；复发转移
Abstract：Objective Find the probable relationship between the tumor site，stage，strategy and the recurrence，metastasis of adenoid cystic carcinoma. Methods 66 cases of adenoid cystic carcinoma were researched in the retrospective way，including 23 cases in parotid，14 cases in sublingual gland，6 cases in submandibular gland，12 cases in pallet gland，8 cases in cheek mucosa and 3 cases in back-lingual.13 of 23 cases of parotid gland adenoid cystic carcinoma were treated by total resection of parotid，9 cases of it were treated by partially resection with reservation of partial deep lope，while 1 case with all deep lope.in all these 23 cases，facial nerve was successfully reserved in 18 cases，while other 5 cases had to be sacrificed.15 of 23 cases had regional neck dissect at the same time.6 cases of pallet adenoid cystic carcinoma were totally dissect with regional neck dissection at the same time while 2 cases without；Other 35 cases of 66 adenoid cystic carcinoma were operated by enlarging resection and regional neck dissection.60 cases of adenoid cystic carcinoma undergo radiation therapy after surgery while 3 cases at the same time.Clinical staging were 10 cases of stage I，42 cases of stage II，8 cases of stage III，6 cases of stage IV. Results All patients represent in following 3～10 years，8 cases recurrent，9 cases metastasis.Higher recurrent and metastasis rate were observed in stage III and IV cases. Conclusion Adenoid cystic carcinoma in sublingual gland，submandibular gland，pallet gland，cheek mucosa and back-lingual should be totally dissected with regional neck dissection at the same time；Facial nerve could be reserved if not be compressed and not adhesive to tumor.Regional neck dissection is not necessary if lymph node is clinically negative.Radiation therapy is recommended in all cases，but necessity of post surgery chemical therapy is not sure.
Key words：Silvery land；Adenoid cystic carcinoma；Surgery；Radiation therapy；Chemical therapy, http://www.100md.com(冼淡等)
, http://www.100md.com
关键词：涎腺腺样；囊性癌；手术放疗；复发转移
Abstract：Objective Find the probable relationship between the tumor site，stage，strategy and the recurrence，metastasis of adenoid cystic carcinoma. Methods 66 cases of adenoid cystic carcinoma were researched in the retrospective way，including 23 cases in parotid，14 cases in sublingual gland，6 cases in submandibular gland，12 cases in pallet gland，8 cases in cheek mucosa and 3 cases in back-lingual.13 of 23 cases of parotid gland adenoid cystic carcinoma were treated by total resection of parotid，9 cases of it were treated by partially resection with reservation of partial deep lope，while 1 case with all deep lope.in all these 23 cases，facial nerve was successfully reserved in 18 cases，while other 5 cases had to be sacrificed.15 of 23 cases had regional neck dissect at the same time.6 cases of pallet adenoid cystic carcinoma were totally dissect with regional neck dissection at the same time while 2 cases without；Other 35 cases of 66 adenoid cystic carcinoma were operated by enlarging resection and regional neck dissection.60 cases of adenoid cystic carcinoma undergo radiation therapy after surgery while 3 cases at the same time.Clinical staging were 10 cases of stage I，42 cases of stage II，8 cases of stage III，6 cases of stage IV. Results All patients represent in following 3～10 years，8 cases recurrent，9 cases metastasis.Higher recurrent and metastasis rate were observed in stage III and IV cases. Conclusion Adenoid cystic carcinoma in sublingual gland，submandibular gland，pallet gland，cheek mucosa and back-lingual should be totally dissected with regional neck dissection at the same time；Facial nerve could be reserved if not be compressed and not adhesive to tumor.Regional neck dissection is not necessary if lymph node is clinically negative.Radiation therapy is recommended in all cases，but necessity of post surgery chemical therapy is not sure.
Key words：Silvery land；Adenoid cystic carcinoma；Surgery；Radiation therapy；Chemical therapy, http://www.100md.com(冼淡等)