唾液腺腺样囊性癌474例临床病理分析

中国口腔颌面外科杂志 ›› 2014, Vol. 12 ›› Issue (2): 126-130.

唾液腺腺样囊性癌474例临床病理分析

张春叶¹, 邓旭霞², 田臻¹, 王丽珍¹, 胡宇华¹, 李蕾¹, 李江¹

1.上海交通大学医学院附属第九人民医院·口腔医学院口腔病理科,上海市口腔医学重点实验室,上海 200011;
2.中国石油中心医院口腔科,河北廊坊 065300

收稿日期:2013-06-20 修回日期:2013-08-26 出版日期:2014-03-10 发布日期:2014-11-06
通讯作者: 李江,Tel:021-23271699-5285,Fax:021-23271238, E-mail: lijiang182000@126.com
作者简介:张春叶(1980-),女,博士,主治医师,E-mail：yezi1806@126.com
基金资助:
国家自然科学基金(81302360); 教育部博士点基金(20120073110085)

Adenoid cystic carcinoma of salivary gland: a clinicopathological study of 474 consecutive cases

ZHANG Chun-ye¹, DENG Xu-xia², TIAN Zhen¹, WANG Li-zhen¹, HU Yu-hua¹, LI Lei¹, LI Jiang¹

1.Department of Oral Pathology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011;
2. Department of Dentistry, Central Hospital of China National Petroleum Corporation. Langfang 065300, Hebei Province, China

Received:2013-06-20 Revised:2013-08-26 Online:2014-03-10 Published:2014-11-06
Supported by:
National Natural Science Foundation of China (81302360); Research Fund for Doctoral Program of Ministry of Education of China(20120073110085)

摘要/Abstract

摘要： 目的：分析474例唾液腺腺样囊性癌(adenoid cystic carcinoma, ACC)的临床病理特征。方法：回顾分析上海交通大学医学院附属第九人民医院口腔病理科诊断为原发性ACC的474例临床病理资料。采用SPSS18.0软件包对数据进行统计学处理。结果：474例ACC中,男女之比为1.03∶1(240∶234);发病年龄11~83岁,平均年龄52岁;腮腺和腭部分别是大小唾液腺中最常见的部位;病程1个月~37 a不等,平均21个月;64%的患者出现不同程度的症状;72%的患者就诊时TNM分期为Ⅱ期和Ⅲ期;组织学上,76%的患者表现为筛状/管状型。组织学类型为实体型者较筛状/管状型者更易发生颈淋巴结转移(P=0.016)。结论：ACC多见于中老年人,腮腺和腭部最常见。临床上多伴有不同程度的症状,组织学表现以筛状/管状型多见,实体型者更易发生颈淋巴结转移。

关键词: 唾液腺, 腺样囊性癌, 临床病理分析

Abstract: PURPOSE: To investigate the clinicopathological features of salivary adenoid cystic carcinoma (ACC) in 474 Chinese patients. METHODS: The clinical and pathological characteristics of 474 primary salivary ACC diagnosed in Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were analyzed. SPSS18.0 software package was used for statistical analysis. RESULTS: Of the 474 ACC cases, the male-to-female ratio was 1.03:1 (240 to 234); the mean age was 52 years (from 11 to 83); the parotid and the palate were the most common locations of major and minor salivary gland respectively; the mean clinical course was 21 months (from 1 month to 37 years); 64% (301/474) patients had clinical symptom; 72%(343/474) patients were TNM stage Ⅱ and Ⅲ; 76%(360/474) patients had cribriform and tubular histological subtype. Tumor with solid pattern was associated with higher cervical lymph node metastasis (P=0.016). CONCLUSIONS: In Chinese population, ACC is more common in elder people and frequently involves the parotid gland and the palate. Most patients have clinical symptoms and histologically, cribriform and tubular types are more common. Patients with solid pattern have higher possibility to develop cervical lymph node metastasis than those with cribriform and tubular patterns.

Key words: Salivary gland, Adenoid cystic carcinoma, Clinicopathological analysis

中图分类号:

R739.8

张春叶, 邓旭霞, 田臻, 王丽珍, 胡宇华, 李蕾, 李江. 唾液腺腺样囊性癌474例临床病理分析[J]. 中国口腔颌面外科杂志, 2014, 12(2): 126-130.

ZHANG Chun-ye, DENG Xu-xia, TIAN Zhen, WANG Li-zhen, HU Yu-hua, LI Lei, LI Jiang. Adenoid cystic carcinoma of salivary gland: a clinicopathological study of 474 consecutive cases[J]. China J Oral Maxillofac Surg, 2014, 12(2): 126-130.

参考文献

[1] Li J, Wang BY, Nelson M, et al. Salivary adenocarcinoma, not otherwise specified: a collection of orphans [J]. Arch Pathol Lab Med, 2004, 128(12): 1385-1394.
[2] Tian Z, Li L, Wang L, et al. Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population [J]. Int J Oral Maxillofac Surg, 2010, 39(3): 235-242.
[3] Ellington CL, Goodman M, Kono SA, et al. Adenoid cystic carcinoma of the head and neck: incidence and survival trends based on 1973-2007 Surveillance, Epidemiology, and End Results data [J]. Cancer, 2012, 118(18): 4444-4451.
[4] da Cruz Perez DE, de Abreu Alves F, Nobuko Nishimoto I, et al. Prognostic factors in head and neck adenoid cystic carcinoma [J]. Oral Oncol, 2006, 42(2): 139-146.
[5] Ciccolallo L, Licitra L, Cantu G, et al. Survival from salivary glands adenoid cystic carcinoma in European populations [J]. Oral Oncol, 2009, 45(8): 669-674.
[6] Kokemueller H, Eckardt A, Brachvogel P, et al. Adenoid cystic carcinoma of the head and neck-a 20 years experience [J]. Int J Oral Maxillofac Surg, 2004, 33(1): 25-31.
[7] Barnes L. World health organization classification of tumours: pathology and genetics head and neck tumours [M]. Lyon: IARC press, 2005.
[8] Huang M, Ma D, Sun K, et al. Factors influencing survival rate in adenoid cystic carcinoma of the salivary glands [J]. Int J Oral Maxillofac Surg, 1997, 26(6): 435-439.
[9] Perzin KH, Gullane P, Clairmont AC. Adenoid cystic carcinomas arising in salivary glands: a correlation of histologic features and clinical course [J]. Cancer, 1978, 42(1): 265-282.
[10] Bianchi B, Copelli C, Cocchi R, et al. Adenoid cystic carcinoma of intraoral minor salivary glands [J]. Oral Oncol, 2008, 44(11): 1026-1031.
[11] Khan AJ, DiGiovanna MP, Ross DA, et al. Adenoid cystic carcinoma: a retrospective clinical review [J]. Int J Cancer, 2001, 96(3): 149-158.
[12] Garden AS, Weber RS, Morrison WH, et al. The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation [J]. Int J Radiat Oncol Biol Phys, 1995, 32(3): 619-626.
[13] Mücke T, Tannapfel A, Kesting MR, et al. Adenoid cystic carcinomas of minor salivary glands [J]. Auris Nasus Larynx, 2010, 37(5): 615-620.
[14] Agarwal JP, Jain S, Gupta T, et al. Intraoral adenoid cystic carcinoma: prognostic factors and outcome [J]. Oral Oncol, 2008, 44(10): 986-993.
[15] Min R, Siyi L, Wenjun Y, et al. Salivary gland adenoid cystic carcinoma with cervical lymph node metastasis: a preliminary study of 62 cases [J]. Int J Oral Maxillofac Surg, 2012, 41(8): 952-957.