原发性腮腺鳞状细胞癌的诊治

目的探讨原发性腮腺鳞状细胞癌（简称鳞癌）的临床特点、治疗和预后因素。方法回顾性分析中国医学科学院肿瘤医院头颈外科1990年1月～2008年8月24例原发性腮腺鳞癌,总结其临床资料、病理结果、生存情况和预后因素。结果Kaplan-Meier法计算全组5年生存率达35.9%,手术肉眼切净肿瘤的患者（n=18）5年生存率达47.9%。初治（n=15）和复发挽救（n=9）患者的5年生产率分别为44.2%和22.2%（P=0.132）,治疗失败的原因主要是局部区域复发。多因素分析提示二次治疗和肿瘤肉眼残存是预后不良的因素。结论原发性腮腺鳞癌恶性程度较高,首次治疗是关键,切除的肿瘤可获得较好的效果,肿瘤肉眼残存或二次治疗的患者预后较差。

Diagnosis and management of primary squamous cell carcinoma of parotid gland

OBJECTIVE To discuss the clinical characteristics,management and prognostic factors of primary squamous cell carcinoma of parotid gland.METHODS The clinical characteristics,survival rate and prognostic factors of 24 cases who treated in our hospital from 1990 to 2008 were retrospectively studied.RESULTS Kaplan-Meier 5 year survival rate was 35.9%.Survival rate of microscopic radical operation cases was 47.9%.Survival rates of initial treatment group（n=15） and salvage group（n=9） were 44.2% and 22.2% respectively（P=0.132）.The main factor of treatment failure was localregional recurrence.Multi-factor analyses showed initial treatment failure and microscopic residual tumor were the factors of poor prognosis.CONCLUSION Primary squamous cell carcinoma of the parotid gland is a highgrade malignant tumor,but satisfactory results can be achieved by radical operation in initial treatment.Usually,incomplete resection and salvage treatment led to poor prognosis.