涎腺导管癌10例临床分析

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。

Salivary Duct Carcinoma: A Clinical Analysis of 10 Cases.

Objective: To evaluate the clinical manifestation, treatment and prognosis of patients with salivary duct carcinoma (SDC). Methods: Clinical data of 10 patients with SDC from Oct. 2007 to Nov. 2014 were collected and retrospectively analyzed. Results: In this study, the included patients with SDC (8 male and 2 female) were aged from 49 years to 89 years with mean age 64.7 years. With 8 cases of parotid gland and 2 cases of submandibular gland, the patients presented regional mass characterized by recent rapid growth and neural impairment. CT images revealed the mass with ill-defined margin and inhomogeneous enhancement. For the treatment, only six patients received post-operative radiotherapy. Follow-up period was 7 months to 97 months. Three patients recurred. The median survival time was 37.5 months. The 1-, 3-, 5-year disease-free survival rates of these 10 patients with SDC were 90% (95% CI: 55-100), 62.5% (95% CI: 24-91) and 57.1% (95% CI: 18-90), respectively. Conclusion: SDC was a rare disease. The clinical manifestation and imaging examination were not outstanding, while pathological report could guide diagnosis. With poor prognosis, surgery was the first choice and post-operative radiotherapy should be performed. Biological therapy might be a novel treatment strategy for SDC.