涎腺癌颈淋巴结转移的临床分析

目的 了解涎腺癌颈淋巴结转移的发生情况,为临床治疗提供参考.方法 选择北京大学口腔医学院具有完整临床及随访资料的涎腺癌患者815例,记录颈部淋巴结转移情况,分析涎腺癌的颈淋巴结转移的发生规律.结果 815例涎腺癌患者的总体颈淋巴结转移发生率11.53%(94/815).颈淋巴结转移发生率位列前3位的肿瘤分别是鳞状细胞癌...     

17例涎腺淋巴上皮癌临床病理分析

目的：涎腺淋巴上皮癌是一种罕见的恶性肿瘤,本文主要探讨涎腺淋巴上皮癌的发病情况、病理特点及其诊治措施。方法：回顾性分析2006—2012年间于南方医科大学南方医院就诊的17例涎腺淋巴上皮癌患者,分析其临床特点与治疗方法对预后的影响。结果：17例中,男10例,女7例;Ⅱ、Ⅲ、Ⅳ期患者分别为7（41．2％）、4（23．5％）、6（35．3％）例。术后平均随访时间为2．56年,随访12例患者情况稳定;5例患者分别在术后3年内出现局部复发和（或）远处转移,其中4例已死亡。结论：涎腺淋巴上皮癌是头颈部恶性程度较高的肿瘤之一,好发于腮腺及下颌下腺。治疗应行原发灶扩大切除及根治性颈淋巴清扫术,并结合放化疗以提高疗效。     

涎腺腺样囊性癌76例预后因素分析

目的 分析涎腺腺样囊性癌的预后并探讨其影响因素.方法 回顾性分析76例涎腺腺样囊性癌的临床资料.大涎腺来源27例(35.5％),小涎腺来源49例(64.5％).Ⅰ期8例(10.5％),Ⅱ期23例(30.3％),Ⅲ期18例(23.7％),Ⅳ期27例(35.5％).计数资料采用x2检验或精确概率法,Kaplan-Meier法计算生存率,组间比较采用Log-rank对数秩检验,Cox比例风险模型进行多因素分析.结果 全组病例区域复发率28.9％,远处转移率21.0％.5年、10年总体生存率分别为73.7％、48.2％;5年、10年无瘤生存率分别为61.8％、39.8％;5年、10年肿瘤相关生存率为74.9％、56.2％.单因素分析结果显示,病理类型、肿瘤分期和周围神经侵犯对涎腺腺样囊性癌生存率的影响有统计学意义(P值均＜0.05).Cox模型多变量分析显示,病理类型、肿瘤分期及周围神经侵犯是影响涎腺腺样囊性癌患者预后的独立危险因素(P值均＜0.05).对于Ⅲ、Ⅳ期患者,放疗组的无瘤生存率与未放疗组相比有升高趋势,但差异无统计学意义(P=0.052).结论TNM分期、病理类型和周围神经侵犯是影响涎腺腺样囊性癌预后的独立危险因素,手术是治疗腺样囊性癌的主要方法,术后放疗可能提高Ⅲ、Ⅳ期患者的无瘤生存时间.     

喉小涎腺癌

作者回顾了1944年初～1982年底经治的18例喉小涎腺癌病例。18例中,腺样囊性癌8例,低分化腺癌 10例。男14例,女4例。平素有吸烟嗜好者11例。腺样囊性癌平均年龄61.5岁。腺癌60岁。18例中,声门上癌14例,声门下癌4例,无单纯声门癌。肉眼观察,均为粘膜下肿块。声门上癌主要表现为声嘶,咽下困难,咽痛。声门下癌则多数表现为呼吸道受累症状。18例的症状持续时间各异,但以晚期病例居多。腺癌中7例有明显颈部结节病变,腺样囊性癌中3例有颈部结节。11例接受手术治疗,多数为全喉切除术加改良或根治性颈廓清术,2例为部分喉切除术。2例单用放疗,5例手术加术前或术后放疗。初次复发后腺样囊性癌患者平均生存期为38.4月,腺癌12.1月。仅腺样     

下鼻甲涎腺导管癌1例

1病例报告患者,男,75岁,因右侧鼻腔渐进性鼻塞伴反复出血1年,于2020年8月16日入院.患者1年前无明显诱因出现右侧鼻腔鼻塞,呈持续性,伴右侧鼻腔反复出血,量少,可自止,伴嗅觉下降,伴头痛,位置固定于头顶部,伴右侧鼻腔胀痛不适,一直未予诊治,症状逐渐加重,为明确诊治遂来我院.     

会厌涎腺混合瘤1例

患者 ,女 ,48岁 ,因声音嘶哑伴吞咽梗阻感半年于 2 0 0 0年 5月 2 3日入院。半年前无明显诱因出现声音嘶哑 ,伴吞咽梗阻感 ,未行任何处理。 2 0 0 0年初因腹痛、发热 ,在当地医院诊断为“急性阑尾炎”行手术治疗。患者术后 3 d出现恶心、呕吐、痰中带血 ,检查发现喉部有一新生物而入我院治疗。体检 :口咽部正常 ,扁桃体无肿大。间接喉镜下见喉咽部有一巨大新生物 ,位于会厌 ,表面不规则 ,可见血管纹。纤维喉镜检查见新生物位于会厌喉面 ,表面有血管纹 ,质硬 ,喉室、声带粘膜光滑 ,未见肿胀及新生物 ,舌根正常。CT报告喉部可见一团状不规则…     

涎腺肿瘤临床实践指导

唾液腺肿瘤依据类型可分为腮腺、颌下腺及小的唾液腺肿瘤。依据前期治疗和临床检查分为未治疗的可切除的，有前期治疗史不能完全切除的及无法切除的三种情况。     

以硬质肿块为表现的耳鼻咽喉小涎腺来源腺样囊性癌(附9例报告)

目的：探讨以硬质肿块为表现的耳鼻咽喉小涎腺来源腺样囊性癌的临床特征,病理特点及预后。方法：回顾性分析9例以硬质肿块为表现的发生于耳鼻咽喉各部位的小涎腺来源腺样囊性癌患者的临床资料。结果：本组患者从出现症状到确诊时间平均为4．3年,随访6个月～15年;9例均复发,死亡5例,其中肺转移3例,骨转移1例,颅内扩散1例;存活4例。带瘤生存时间最长为6年3个月。结论：本组9例病理类型均为实心型小涎腺来源腺样囊性癌,均有以硬质肿块生长为主要表现的特点,应及早诊断,第1次行扩大手术,术后辅以放疗,其预后远较其他类型差。     

60例咽旁间隙涎腺源性肿瘤的回顾性分析

目的 总结并分析咽旁间隙涎腺源性肿瘤的临床特征、诊断方法、外科治疗方法、术后并发症及预后.方法 回顾性分析郑州大学第一附属医院2010年11月～2019年7月收治的60例原发或侵占咽旁间隙的涎腺源性肿瘤患者的临床资料.结果 60例患者中,男28例,女32例,年龄22～84岁.最常见的临床表现为发现口咽部包块.所有患者均...     

Malignant minor salivary gland tumors of the larynx

OBJECTIVE: To report our experience in treating patients with malignant minor salivary gland tumors of the larynx. DESIGN: Thirty-three-year retrospective study. SETTING: Tertiary referral center specializing in head and neck surgery. PATIENTS: Twelve patients with malignant minor salivary gland tumors of the larynx were identified from a search of the institutional databases and pathology records at Memorial Sloan-Kettering Cancer Center, New York, NY, between the years 1970 and 2003. All slides were independently reviewed by 2 pathologists (R.G. and D.C.). Details on patient and tumor characteristics, as well as treatment and surgical outcome, were recorded. RESULTS: Ten patients (83%) had adenoid cystic carcinoma and 2 (17%) had myoepithelial carcinoma. Five (42%) were located in the supraglottis and 7 (58%) in the subglottis. Ten (83%) had surgery (6 with adjuvant radiotherapy) and 2 (17%) were treated with radiotherapy alone. Of the 10 patients who had surgery, total laryngectomy was required in 6 (60%), supraglottic horizontal laryngectomy in 2 (20%), and cricotracheal resection in 2 (20%). With a median follow-up of 55 months (range, 1-194 months), 10 patients are alive, 6 of whom have no evidence of disease. Seven patients (58%) developed recurrent disease, 2 of whom had local recurrence alone, 1 had regional recurrence alone, 3 had distant recurrence alone, and 1 had local and distant recurrence. CONCLUSIONS: Up to 60% of patients with malignant minor salivary gland tumors of the larynx will develop recurrent disease locally, regionally, or at distant sites. In adenoid cystic carcinoma, regional recurrence is rare, but distant recurrence is common and may occur up to 10 years after the index therapy. For both adenoid cystic and myoepithelial carcinoma, partial surgery is possible in selected cases, but because of the high propensity for submucosal spread and perineural and lymphovascular invasion, total laryngectomy is usually recommended.     

小涎腺肿瘤的外科治疗

目的:分析和探讨小涎腺肿瘤的临床特征和诊疗要点。方法:对我院1997～2004年收治的54例小涎腺肿瘤患者的临床特征和治疗效果作回顾性分析。结果:54例患者中失访16例,在随访到的38例患者中,因肿瘤复发死亡4例,其中2例鼻腔腺样囊性癌分别于术后2年和3年死于肿瘤复发,1例喉肌上皮癌术后3年死于肿瘤复发,1例鼻窦黏液表皮样癌术后1年5个月死于肿瘤复发;2例鼻窦腺样囊性癌术后复发,再次手术后无瘤生存;1例鼻腔腺样囊性癌术后11个月复发,行伽玛刀治疗及中药治疗带瘤生存;其余患者均无瘤生存。结论:小涎腺肿瘤分布广泛,病理类型繁多,本组病例以恶性肿瘤多见,占81.4%。不同部位的肿瘤和不同病理类型的肿瘤临床表现和治疗方案各不相同。对良性肿瘤多采用肿瘤摘除术。而对恶性肿瘤治疗,手术结合放疗是主要的治疗方案。成功的关键是完整地切除肿瘤和有足够的切缘。     

喉神经内分泌癌九例临床病理分析

目的 总结喉神经内分泌癌患者的临床表现、治疗方法及预后.方法 回顾性分析2005年5月至2011年6月共收治9例喉神经内分泌癌患者的临床资料,男6例,女3例;年龄35～65岁,中位年龄58岁.结果 治疗方法采取单纯手术5例,手术加术后放化疗4例.2例喉典型类癌患者随访28、30个月未复发;3例喉不典型类癌患者,其中1例在随访至36个月时复发,再次手术后已随访30个月,未见局部复发及远处转移,另2例分别随访15、20个月,均未复发;3例喉小细胞神经内分泌癌患者,1例随访18个月仍存活,另2例分别于术后11及14个月死亡;喉副神经节瘤1例,随访32个月未复发.结论 喉神经内分泌癌诊断有赖于临床特点、组织病理学及免疫组化检查.本病并无统一治疗方案,不同病理亚型的治疗方法及预后不同,对恶性程度较高的亚型主张采取以手术为主的综合治疗方案.     

喉恶性纤维组织细胞瘤

目的　探讨喉恶性纤维组织细胞瘤的诊断和治疗。方法　对 9例喉恶性纤维组织细胞瘤的临床、病理、诊断、治疗和预后进行回顾性分析。结果　 9例喉恶性纤维组织细胞瘤患者 ,男 8例 ,女 1例 ;年龄 43～ 87岁 ,平均 56岁。喉恶性纤维组织细胞瘤诊断较困难 ,3例标本经多次活检 ,5例标本进行免疫组化检查协助诊断。喉恶性纤维组织细胞瘤以手术治疗为主 ,7例喉恶性纤维组织细胞瘤患者行喉全切除术 ,2例行喉部分切除术。随访 3年以上 ,在访的 6例喉恶性纤维组织细胞瘤无 1例死亡。结论　喉恶性纤维组织细胞瘤容易误诊 ,有时需免疫组化鉴别诊断。喉恶性纤维组织细胞瘤手术切除力求彻底 ,可根据肿瘤范围大小决定不同的手术方式     

The relationship between nuclear DNA content in salivary gland tumors and prognosis

Summary Differences in prognosis between salivary gland mucoepidermoid tumors and acinic cell tumors were compared by means of conventional histopathological grading and nuclear DNA content which was assessed cytochemically by a scanning cytophotometric procedure. The mucoepidermoid tumors were found to show a stronger correlation between histopathological grading and prognosis than did the acinic cell tumors. By using DNA quantification, valuable additional information could be obtained for predicting the behavior of the mucoepidermoid tumors, whereas there was no correlation between DNA content and prognosis for the acinic cell tumors. Regarding the relatively benign clinical course of most mucoepidermoid tumors, the term tumor — as proposed by the World Health Organization's classification — seems appropriate. In contrast, the more severe clinical courses of the acinic cell tumors justify the use of the term carcinoma instead.Presented at the First European Congress of Oto-Rhino-Laryngology and Cervico-Facial Surgery, Paris, 26–29 September 1988Dedicated to Jean Papa Chick of Meru, France, with affection     

Prognostic significance of histopathological parameters in cancer of the larynx

In this study we investigated the prognostic significance of differentiation, the mode of tumor invasion to surrounding tissues, the microscopic appearance of tumor, peritumoral lymphocytic infiltration and cartilage involvement according to disease-free survival, and the recurrence and presence of cervical lymph node metastasis in cancer of the larynx. Only the mode of tumor invasion to surrounding tissues was significantly related to survival (P < 0.05). The patients with “well-defined margin” tumors survive significantly longer than those with “groups of cells, no distinct margin.” Patients with supraglottic tumors and a mode of invasion other than “well-defined margin” have a significantly higher risk of recurrence (P < 0.05) and therefore require adjuvant therapy. Patients with poorly differentiated, cartilage invading, ulcerative supraglottic tumors, and patients with glottic tumors having diffusely infiltrating margins, certainly need elective neck dissection (P < 0.05). According to the multivariant analysis, none of the factors significantly affect disease-free survival independently (P > 0.15). According to multiple logistic regression and cox regression analysis, in decreasing order of significance, the mode of invasion, microscopic tumor appearance and lymphocytic infiltration significantly affect the recurrence and time between surgery and the development of recurrence independently (P < 0.15). Received: 4 December 1997 / Accepted: 12 June 1998     

Basaloid squamous cell carcinoma of the supraglottic larynx

Basaloid squamous cell carcinoma (BSC) is regarded as a variant of squamous cell carcinoma, but displays distinct morphological and biological features as well as a different clinical course. The tumor is frequently seen in the head and neck and is preferentially located in the larynx, especially in supraglottic sites. Ten patients with BSC of the supraglottic larynx were treated from 1991 to 1995 at the Medical Faculty of the University of Istanbul. Results of treatment were compared retrospectively with a control group consisting of 44 patients with well-differentiated squamous cell carcinomas. Ages, ¶localizations, stages and treatment procedures were similar. In both groups mean survival, nodal involvement and distant metastases were comparable although the local ¶(laryngeal) recurrence rate in patients with early supraglottic (T2) disease in the BSC group after conservative partial surgery was distinct compared to the control group (P < 0.05). These results indicate that conservative surgery should be assessed with caution in patients with BSC, and postoperative irradiation be taken into consideration.     

Malignant salivary gland tumors of the palate.

Twenty patients with malignant salivary gland tumors of the hard and soft palate were seen at the University of Virginia Hospital from 1956 through 1975. The characteristics of the tumors, including symptoms and histology are reviewed and the results of treatment are analyzed. In particular, the place of radiotherapy in their management has been examined. Primary control by initial surgery alone was achieved in 60% (9/15) of the cases, and, when those patients who received radiotherapy for residual disease or salvage are included, the primary control was 94% (16/17). Five- and ten-year determinate survival rates were 88% and 67%, respectively. From this retrospective analysis and a review of the literature, it appears that radiotherapy has made a very positive contribution to the management of these tumors.     

鼻咽喉非霍奇金淋巴瘤64例临床分析

［摘要］目的：探讨鼻咽喉非霍奇金淋巴瘤的诊断、治疗和预后。方法:回顾分析鼻咽喉非霍奇金淋巴瘤64例的临床资料,评价影响淋巴瘤的预后因素。结果:本组64例中,T细胞淋巴瘤29例,NK/T细胞淋巴瘤16例,B细胞淋巴瘤16例,3例未分型。Ann Arbor分期：Ⅰ期31例,Ⅱ期21例,Ⅲ期11例,Ⅳ期1例。25例行化疗,27例行化疗加放疗,5例行放疗。3年总生存率为67.24％,单纯化疗的3年生存率和化疗加放疗的3年生存率差异无统计学意义（P＝0.07）。单因素分析表明,Ann Arbor分期、国际预后指数（IPI）、一般状况和乳酸脱氢酶（LDH）是影响预后的因素。多因素Cox回归模型分析表明,仅IPI是影响预后的独立因素。结论:鼻咽喉非霍奇金淋巴瘤以鼻和鼻窦T细胞淋巴瘤多见,化疗加放疗并未改善疗效,IPI是判断预后的独立指标。