论文部分内容阅读
目的:分析涎腺导管癌的临床特点以及治疗效果。方法:回顾分析2007年10月~2014年11月经术后病理确诊且完成随访患者的临床资料。结果:10例患者中,男性8例,女性2例,年龄46~89岁,平均(64.7±12.7)岁。8例累及腮腺,2例累及颌下腺。临床表现为腮腺区或颌下区肿物,可伴有近期突然增大,局部神经侵犯症状。影像学发现局部占位性病变,边界多为不清,不均匀强化。10例患者均行手术治疗,术后6例予以放疗,4例未放疗。随访至术后7~97个月,中位无病生存时间为37.5个月。10人均随访满1年,其中1例复发,1年无病生存率为90%(95%CI:55-100),8人随访满3年,其中3人复发,3年无病生存率为62.5%(95%CI:24-91),7人随访满5年,其中3人复发,5年无病生存率为57.1%(95%CI:18-90)。结论:涎腺导管癌较罕见,临床表现及辅助检查无明显特异性,确诊主要依靠病理结果。该疾病预后较差,手术治疗为首选方法,术后需联合放疗。生物靶向治疗有望成为新的辅助治疗方式之一。
Objective: To analyze the clinical features and therapeutic effects of salivary duct carcinoma. Methods: The clinical data of patients who were confirmed by pathology and were followed up from October 2007 to November 2014 were retrospectively analyzed. Results: Of the 10 patients, 8 were males and 2 were females, ranging in age from 46 to 89 years with an average of (64.7 ± 12.7) years. 8 cases involving the parotid gland, 2 cases involving the submandibular gland. Clinical manifestations of the parotid gland area or submandibular area tumor, may be accompanied by a sudden increase recently, local nerve invasion symptoms. Imaging findings of local mass lesions, the border mostly unclear, uneven enhancement. All the 10 patients underwent surgery, 6 patients received radiotherapy and 4 patients did not receive radiotherapy. Followed up to 7 to 97 months after surgery, the median disease-free survival time was 37.5 months. Ten patients were followed up for one year. Among them, one patient relapsed with a one-year disease-free survival rate of 90% (95% CI: 55-100). Eight patients were followed up for 3 years, of whom 3 were relapsed. 62.5% (95% CI: 24-91). Five of the seven patients were followed up for 5 years. Three of them relapsed with a 5-year disease-free survival rate of 57.1% (95% CI: 18-90). Conclusions: Salivary gland ductal carcinoma is rare, and clinical manifestations and auxiliary examination have no obvious specificity. The diagnosis mainly depends on the pathological findings. The disease prognosis is poor, surgical treatment is the preferred method, postoperative radiotherapy combined. Bio-targeted therapy is expected to become one of the new adjuvant therapies.