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目的:探讨涎腺黏液表皮样癌的诊断、治疗及疗效。方法:收集2001～2008年收治的20例涎腺黏液表皮样癌病例资料进行回顾分析。结果:20例黏液表皮样癌中腮腺13例(65%),副腮腺1例(5%),腭部2例(10%),颌骨2例(10%),颌下腺1例(5%),颊黏膜1例(5%)。其中11例为高分化,4例为中分化,1例为低分化,其余未分级。20例患者均行手术切除(切除范围视肿瘤部位及分级而定),其中4例行同侧颈部选择性淋巴清扫术,17例行术后放疗。3例因面神经受累同时切除面神经,其中1例行面神经吻合术,1例行耳大神经移植术,手术半年后患者面神经功能恢复良好。随访1～5年,失访2例,平均随访时间2.44年。获随访的18例均无复发。结论:手术切除时应重视原发灶切除的彻底性,在疑有颈部淋巴结转移时应同期进行选择性颈部淋巴清扫术;对于术中切除不彻底,有颈部淋巴结转移,病理结果显示为中低分化病例应进行术后放疗。
Objective: To investigate the diagnosis, treatment and efficacy of salivary mucoepidermoid carcinoma. Methods: Twenty cases of mucoepidermoid carcinoma of the salivary glands admitted from 2001 to 2008 were retrospectively analyzed. Results: Thirteen cases (65%) of parotid gland, one case of accessory parotid gland (10%), two cases of palate (10%), two cases of mandible (10%) and one case of submandibular gland ), Buccal mucosa in 1 case (5%). Among them, 11 were well-differentiated, 4 were moderately differentiated, 1 was poorly differentiated and the rest were not graded. Twenty patients underwent surgical resection (resection scope depends on tumor location and grading). Four patients underwent ipsilateral neck selective lymph node dissection and 17 patients received postoperative radiotherapy. Facial nerve was excised in 3 cases due to facial nerve involvement. One case had facial nerve anastomosis and one case received maxillary nerve transplantation. The facial nerve function recovered well in six months after operation. Follow-up 1-5 years, lost two cases, the average follow-up time of 2.44 years. No follow-up of 18 cases of recurrence. Conclusion: The resection should pay attention to the thoroughness of resection of the primary tumor. When cervical lymph node metastasis is suspected, selective cervical lymph node dissection should be carried out concurrently. For incomplete resection, cervical lymph node metastasis and pathological findings For low and moderate differentiation cases should be postoperative radiotherapy.