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目的:探讨原发灶不明颈部淋巴结转移癌(CCUP)的临床特点和治疗情况。方法:纳入15例2000年1月至2015年4月诊治的CCUP患者,回顾性分析其临床特点和治疗情况。结果 :全组CCUP患者中男13例,女2例,鳞癌11例,腺癌1例,低分化癌2例,淋巴上皮样癌1例,全组初治年龄25~71岁。单侧颈部包块14例,双侧颈部包块1例。颈部淋巴结分区:Ⅰ区2例(8%),Ⅱ区14例(54%),Ⅲ区6例(23%),Ⅳ区4例(15%);分期:N_14例(26.7%),N29例(60.0%),N32例(13.3%)。手术治疗14例,放射治疗7例,化疗11例。随访6~50个月,完全缓解11例,部分缓解2例,进展2例,总体有效率为86.7%。全组1、3年总生存率分别为80%、30%,中位总生存期为30.4个月;全组1、3年无进展生存率分别为76.9%、19.2%,中位无进展生存期为20.4个月;出现原发灶2例;死亡11例。结论:CCUP是一种临床少见的疾病,国内其局部控制率和总体生存率较国外低,结合放射治疗的综合治疗可改善其预后。
Objective: To investigate the clinical features and treatment of primary malignant cervical lymph node metastasis (CCUP). Methods: Fifteen CCUP patients who were diagnosed and treated from January 2000 to April 2015 were enrolled. The clinical features and treatment were retrospectively analyzed. Results: There were 13 males and 2 females in CCUP group, 11 cases of squamous cell carcinoma, 1 case of adenocarcinoma, 2 cases of poorly differentiated carcinoma and 1 case of lymphoepithelial carcinoma. The initial treatment group was 25-71 years old. Unilateral neck mass in 14 cases, bilateral neck mass in 1 case. (N = 14 (26.7%), n = 14 (n = 14, n = 14) N29 cases (60.0%), N32 cases (13.3%). Surgical treatment in 14 cases, radiotherapy in 7 cases, chemotherapy in 11 cases. All cases were followed up for 6 to 50 months. Complete remission was achieved in 11 cases, partial remission in 2 cases and progression in 2 cases. The overall effective rate was 86.7%. The overall 1, 3-year overall survival rate was 80%, 30%, the median overall survival was 30.4 months; 1, 3-year progression-free survival rates were 76.9%, 19.2%, median progression-free survival The duration was 20.4 months. There were 2 primary lesions and 11 deaths. Conclusion: CCUP is a rare clinical disease. Its local control rate and overall survival rate are lower than those in other countries. Combined treatment with radiotherapy can improve its prognosis.