涎腺粘液表皮样癌诊断与治疗

目的：探讨涎腺黏液表皮样癌的诊断、治疗及疗效。方法：收集2001～2008年收治的20例涎腺黏液表皮样癌病例资料进行回顾分析。结果：20例黏液表皮样癌中腮腺13例（65%）,副腮腺1例（5%）,腭部2例（10%）,颌骨2例（10%）,颌下腺1例（5%）,颊黏膜1例（5%）。其中11例为高分化,4例为中分化,1例为低分化,其余未分级。20例患者均行手术切除（切除范围视肿瘤部位及分级而定）,其中4例行同侧颈部选择性淋巴清扫术,17例行术后放疗。3例因面神经受累同时切除面神经,其中1例行面神经吻合术,1例行耳大神经移植术,手术半年后患者面神经功能恢复良好。随访1～5年,失访2例,平均随访时间2.44年。获随访的18例均无复发。结论：手术切除时应重视原发灶切除的彻底性,在疑有颈部淋巴结转移时应同期进行选择性颈部淋巴清扫术;对于术中切除不彻底,有颈部淋巴结转移,病理结果显示为中低分化病例应进行术后放疗。

Retrospective analysis of mucoepidermoid carcinoma of salivary gland in 20 cases

Objective：In this retrospective study we analyzed our experience with mucoepidermoid carcinoma（MEC） of the salivary glands to explore the diagnosis,treatment and curative effect of MEC. Method：A total of 20 patients were treated between 2001 and 2008 at the Department of Oral and Maxillofacial Surgery,Shenzhen Hospital Peking University. Result：All patients underwent surgery resection with a curative intent,4 of them underwent selective neck dissection at the same time,and in 17 of them treatment was supplemented by radiotherapy after operation. Follow up ranged from 1 to 5 years （Average：2.44 years）. 13 （65 %）MECs originated from the major salivary glands with the majority located in the parotid. Histologically,55 % of tumors were classified as low grade,20 % as intermediate and 5 % as high-grade MECs. 17 of these patients received adjuvant radiotherapy and no one developed local recurrence. Conclusion：The key factor to ensure the curative effect is to expand the margin of the lesion. Suspected metastatic lymph node indicate that selective neck dissection will be done at the same time. In the three situations postoperative radiotherapy will be done：①inadequate resection;②Suspected metastatic lymph node;③high or intermediate grade MEC.