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目的:探讨唾液腺透明细胞癌的诊断和治疗原则。方法:2002年8月-2007年1月间共收治唾液腺透明细胞癌11例,均行手术扩大切除。3例有颌骨破坏者,分别行上颌骨次全切除、双侧上颌骨部分切除和下颌骨节段性切除,5例颈淋巴结肿大者行颈淋巴清扫术,对术后软硬组织缺损采用不同方法修复,5例辅以术后放疗。结果:11例术后病理均为唾液腺透明细胞癌,4例颈淋巴结转移。透明细胞免疫组化CK均(+),S-100均(-),9例SMA(-)。除1例前臂皮瓣部分坏死外,11例伤口均愈合良好,无其他并发症。所有患者术后已随访0.5～5a,未发现局部肿瘤复发、颈淋巴结和远处转移。结论:唾液腺透明细胞癌是一种少见的唾液腺低度恶性肿瘤,免疫组化检查有助于确诊治疗首选局部广泛切除,颈淋巴结转移者应行颈淋巴清扫术,术后放疗主要用于局部复发或颈淋巴结转移者,患者一般预后良好。
Objective: To investigate the diagnosis and treatment of salivary gland clear cell carcinoma. Methods: From August 2002 to January 2007, 11 cases of clear cell carcinoma of salivary gland were treated with surgical resection and expansion. Three patients with jaw disruption were performed subtotal maxillary resection, bilateral maxillary partial resection and mandibular segmental resection. Five cases of cervical lymph node enlargement were performed cervical lymph node dissection, the use of postoperative soft and hard tissue defects Different ways to repair, 5 cases supplemented by postoperative radiotherapy. Results: All 11 cases were pathologically salivary gland clear cell carcinoma and 4 cases had cervical lymph node metastasis. Clear cell immunohistochemical CK (+), S-100 (-), 9 cases of SMA (-). Except for 1 case of forearm flap partial necrosis, all 11 wounds healed well without other complications. All patients were followed up 0.5 ~ 5a, no local tumor recurrence, cervical lymph node and distant metastasis were found. Conclusions: Salivary gland clear cell carcinoma is a rare low-grade salivary gland tumor. Immunohistochemical examination is helpful for the diagnosis and treatment of the first choice of local excision. Cervical lymph node metastasis should be performed with cervical lymph node dissection. Postoperative radiotherapy is mainly used for local recurrence Or cervical lymph node metastasis, the general prognosis of patients with good.