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目的 :探讨上颌窦腺样囊性癌 (ACC)的诊断及手术加术后放疗的治疗效果 ,并分析与预后有关的因素。方法 :回顾性分析 1992～ 1999年 14例上颌窦ACC患者的临床资料 ,用Kaplan Meier法计算 5年及 10年无瘤生存率。结果 :随访 3～ 10年 ,平均 6 7.2个月。T2 N0 M0 2例 ,健在 ,无复发及转移 ;T3 N0 M0 4例 ,其中 1例术后5 7个月复发 ,3例健在 ,无复发及转移 ;T4N0 M0 8例 ,其中 2例术后分别于 36个月、4 0个月因局部复发、颅内侵犯死亡 ,1例术后 39个月复发 ,1例术后 96个月全身转移 ,4例健在 ,无复发及转移。 5年无瘤生存率为 72 .5 % ,10年无瘤生存率为 5 4 .4 %。结论 :上颌窦ACC早期症状不典型 ,容易误诊和漏诊 ;彻底的手术切除加术后放疗可以降低术后复发的机会 ,提高治愈率。肿瘤临床分期及手术切缘情况与预后有关
Objective: To investigate the diagnosis of maxillary sinus adenoid cystic carcinoma (ACC) and the effect of surgery and postoperative radiotherapy, and to analyze the prognostic factors. Methods: The clinical data of 14 patients with maxillary sinus in 1992 ~ 1999 were retrospectively analyzed. The 5-year and 10-year tumor-free survival rates were calculated by Kaplan Meier method. Results: The patients were followed up for 3 to 10 years with an average of 62.2 months. T2 N0 M0 2 cases, no recurrence and metastasis; T3 N0 M0 4 cases, of which 1 case of recurrence after 5 7 months, 3 cases of non-recurrence and metastasis; T4N0 M0 8 cases, of which 2 cases were postoperative At 36 months and 40 months, the patients died of intracranial invasion due to local recurrence. One patient relapsed 39 months after operation. One patient had systemic metastasis at 96 months and 4 patients had no recurrence and metastasis. The 5-year disease-free survival rate was 72.5%, and the 10-year disease-free survival rate was 54.4%. Conclusion: The early symptoms of maxillary sinus are not typical, easily misdiagnosed and missed diagnosis; complete surgical resection plus postoperative radiotherapy can reduce the chance of postoperative recurrence and improve the cure rate. Cancer staging and surgical margins and prognosis