14l例腮腺包块临床分析

目的 通过141例腮腺包块的临床分析，提高对腮腺包块的诊断和治愈率。方法 对我院1979—1998年收治的141例腮腺包块进行回顾性分析，按病理学分类，其中良性肿瘤101例，恶性肿瘤32例，其它病变8例，所有包块均行手术治疗，对恶性肿瘤术后酌情放疗。结果 132例腮腺包块均经手术治愈，2例混合瘤及7例恶性肿瘤术后复发。结论 腮腺包块的正确诊断对治疗方法有重要意义，恶性肿瘤综合治疗可提高患者生存率。     

141例腮腺包块临床分析

目的　通过 14 1例腮腺包块的临床分析 ,提高对腮腺包块的诊断和治愈率。方法　对我院 1979～1998年收治的 14 1例腮腺包块进行回顾性分析 ,按病理学分类 ,其中良性肿瘤 10 1例 ,恶性肿瘤 3 2例 ,其它病变 8例 ,所有包块均行手术治疗 ,对恶性肿瘤术后酌情放疗。结果　 13 2例腮腺包块均经手术治愈 ,2例混合瘤及 7例恶性肿瘤术后复发。结论　腮腺包块的正确诊断对治疗方法有重要意义 ,恶性肿瘤综合治疗可提高患者生存率。     

腮腺区包块的临床诊断与治疗分析

目的：通过对我院近9年192例腮腺包块的统计分析,探讨腮腺包块分布类型,以及最佳治疗方案。方法：回顾分析192例腮腺包块病例,随访其治疗效果,并进行进行统计分析。结果：192例腮腺肿瘤中,良性肿瘤125例,恶性肿瘤34例,非肿瘤性包块33例。腮腺包块中良性肿瘤占大多数,常见类型为淋巴乳头状囊腺瘤和多形性腺瘤。恶性肿瘤所占比例较少,以黏液表皮样癌和腺样囊性癌居多。非肿瘤性包块多为炎性包块。肿瘤治疗以手术切除为主。炎性包块多采用抗炎治疗。结论：腮腺区包块涵盖的疾病复杂,应根据肿瘤性质、位置及范围选择合适的治疗或手术方案。     

儿童腮腺肿瘤52例临床分析

目的：总结儿童腮腺肿瘤的发病情况、临床病理特点及诊断治疗。方法：对1980．9．—1999．5．收治的52例16岁以下儿童腮腺肿瘤的病案资料进行回顾性分析。结果：52例儿童腮腺肿瘤中，良性肿瘤36例，占69．2％，恶性肿瘤16例，占30．8％；良性肿瘤中血管病最多，占良性肿瘤的41．1％，恶性肿瘤中粘液表皮样癌最多，占恶性肿瘤的56．2％。42例经手术治疗，其中16例恶性肿瘤术后进行放疗，10年生存率83．3％。结论：儿童腮腺肿瘤中脉管瘤最多见，实质性肿瘤中恶性肿瘤较多，手术治疗为主要治疗方法，总体上预后治疗好。     

腮腺区包块诊断分析

目的:提高对腮腺区包块的诊断水平。方法:收集5年间296例腮腺区包块的临床资料,对其一般情况、疾病构成、临床表现、诊断方法等进行分析。结果:男、女之比约1.19∶1,年龄最小1岁,最大83岁;多形性腺瘤80例,占腮腺区包块的27%,占腮腺区良性肿瘤的50%;Warthin瘤50例,占腮腺区包块的16.9%,占腮腺区良性肿瘤的31.3%;炎性包块27例,占腮腺区包块的9.1%。黏液表皮样癌14例,占腮腺区包块的4.7%,占腮腺区恶性肿瘤的29.2%;腺样囊性癌7例,癌在多形性腺瘤中7例,均占腮腺区包块的2.4%、腮腺区恶性肿瘤的14.6%;鳃裂囊肿6例,占腮腺区包块的2.0%;多形性腺瘤以40～49岁年龄组及50～59岁年龄组最多见(χ2检验,P<0.005),Warthin瘤以50～59岁年龄组、60～69岁年龄组、70～79岁年龄组最多见,且40岁以前其发病率为0(χ2检验,P<0.005);炎性包块可见于任一年龄组,且以60～69岁年龄组最多见(χ2检验,P<0.005)。结论:腮腺区包块涵盖的疾病复杂,表现多样,应结合其临床表现、B超、CT、MRI等影像学检查、细针吸细胞学检查、术中快速冰冻病理检查等综合考虑选择合适的治疗或手术方案。     

颌下区包块103例临床分析

目的：总结颌下区包块的诊断和治疗方法。方法：对103例颌下区包块诊断、治疗方法进行回顾性分析。结果：103例颌下区包块中以慢性颌下腺炎为主,囊性病变中以舌下腺囊肿口外型多见,良性肿瘤中以多形性腺瘤为主,恶性肿瘤所占比例较小。结论：颌下区包块病种较多,需详细询问病史及认真临床检查并辅以穿刺、B超、CT等手段,多可明确诊断;肿瘤则需行术前穿刺切取活检及术中冰冻切片检查;治疗方法主要以手术为主。     

腮腺深叶肿瘤41例临床病例分析

目的：总结腮腺深叶肿瘤的诊断及治疗方法。方法：收集41例腮腺深叶肿瘤的临床资料进行回顾性分析,对诊断、手术方式及临床效果进行比较评价。结果：肿瘤直径大于4cm者37例,最大直径14cm;41例中腮腺混合瘤31例,基底细胞腺瘤2例,肌上皮瘤1例,粘液表皮样癌3例,腺泡细胞癌2例,恶性混合瘤2例。治疗办式：肿瘤小于6cm,术前细胞学检查为良性肿瘤者保留面神经腮腺深叶摘除术;肿瘤大于6cm者,保留面神经伞腮腺摘除术;恶性肿瘤全腮腺及面神经切除＋颈淋巴结清扫术。良性肿瘤随诊1～7年无复发。恶性肿瘤4年后复发3例。结论：腮腺深叶肿瘤在发病情况、临床表现等方面具有自身的特点,应根据肿瘤的大小、位置、肿瘤性质采取不同的手术方式。     

腮腺肿物231例临床诊断和治疗分析

目的:分析231例腮腺肿瘤的临床病理类型和手术治疗效果,以期提高诊治水平。方法:腮腺肿物患者231例,术前常规进行B超和CT检查,术中完整切除肿瘤送冰冻活检,良性肿瘤主要采取肿瘤和腮腺浅叶切除术;恶性肿瘤采取肿瘤和腮腺全切术,部分病例附加区域淋巴结清扫术。对冰冻活检和常规石蜡切片诊断资料进行比较分析。结果:本组168例腮腺良性肿瘤,手术后复发5例(3.0%);63例恶性肿瘤,手术后复发11例(17.5%),术中冰冻和术后病理蜡片,良性肿瘤诊断符合率达97.0%,恶性肿瘤诊断符合率为98.9%。结论:B超、CT对肿瘤定位十分有益,选择适当的手术方法可减少创伤和并发症,并降低术后复发率。     

腮腺肿瘤112例临床分析

目的：对腮腺肿瘤的临床和病理学特点进行分析，探讨诊断和治疗中的注意事项。方法：对1985～2005年间收治的112例腮腺肿瘤病例的临床和病理学特点进行回顾性分析。结果：112例腮腺肿瘤男性多于女性。年龄14～80岁。良性肿瘤84例，占75％，恶性肿瘤28例，占25％。B超诊断符合率86．4％。细针吸细胞学定性诊断符合率92．9％，组织类型鉴别较困难。24例腮腺良性肿瘤直径〈2cm者行肿瘤加瘤周正常腺体切除术，获得随访18例，1例腺淋巴瘤在其它部位复发。结论：术前定性诊断应根据肿瘤的部位、大小及患者的情况选择合适的检查方法，疑难病例手术中冰冻活体组织检查是确诊的可靠依据。小的腮腺良性肿瘤实施瘤周正常腺体切除术，不增加复发率，并能减少腮腺手术的并发症。     

腮腺区肿瘤磁共振水成像的临床应用研究

目的：探讨磁共振水成像对腮腺区肿瘤的诊断及治疗的指导意义。方法：对22例术前初步诊断为腮腺区肿瘤的患者进行磁共振及水成像检查，结合临床资料综合制定手术方案。其中15例行保留面神经的全腮腺切除术，6例施行了保留部分腮腺及导管的功能性手术，1例仅接受局部包块切除。结果：①腮腺肿瘤磁共振水成像较普通的X线腮腺造影具有简单、无创、安全以及三维成像等优点；②磁共振以及水成像、三维重建能够更全面立体地提供腮腺肿瘤的信息。结论：磁共振水成像术对腮腺肿瘤的手术治疗具有指导意义。经水成像显示有腮腺导管系统破坏的肿瘤可行保留面神经的全腮腺切除术；对经水成像显示具有完整腮腺导管系统的良性肿瘤应考虑腮腺的功能性手术。     

谷胱甘肽过氧化物酶-3在腮腺多形性腺瘤中的表达及意义

目的 :研究谷胱甘肽过氧化物酶-3(glutathione peroxidase-3,GPX-3)基因及蛋白在腮腺良、恶性多形性腺瘤中的表达,以明确GPX-3与腮腺多形性腺瘤发生、发展的相关性,为临床预测腮腺多形性腺瘤的发生及恶变提供理论依据。方法:采用荧光定量PCR和蛋白免疫印迹法检测30例腮腺多形性腺瘤,30例腮腺多形性腺瘤的瘤旁2 cm腺体组织,以及10例恶性腮腺多形性腺瘤中的GPX-3 mRNA及蛋白的表达,对其相对表达量进行统计学分析。结果:GPX-3 mRNA和蛋白在腮腺良、恶性多形性腺瘤中的表达明显低于瘤旁腺体组织,且在腮腺恶性多形性腺瘤中的表达最低,差异有统计学意义(P<0.01)。GPX-3在腮腺多形性腺瘤中的表达与患者的年龄、性别及肿瘤大小无关,差异无统计学意义(P>0.05),且GPX-3在腮腺多形性腺瘤中的表达与肿瘤TNM分期及恶性成分比例有关,其差异有统计学意义(P<0.05)。结论:GPX-3在腮腺良性多形性腺瘤中低表达,且在腮腺恶性多形性腺瘤中的表达最低,提示GPX-3的低表达与腮腺多形性腺瘤的发生及恶变密切相关。     

Wide excision of accessory parotid gland with anterior approach

Accessory parotid gland tissue has been described as salivary tissue adjacent to the Stensen duct that is distinctly separate from the main body of the parotid gland. Of all parotid gland tumors, 1% to 8% arise from the accessory parotid gland. Little is known about the accessory parotid gland, and it is seldom mentioned in the literature. Between 1999 and 2010, we have treated and followed 8 patients with tumors of the accessory parotid gland. There were 5 males and 3 females with a mean age of 35 years. They all presented with an asymptomatic cheek mass, and 4 of them underwent fine-needle aspiration. Ultrasound or computed tomographic scan was used in all patients. All the patients underwent surgical intervention with standard parotidectomy incision and anterior extension. The mean follow-up time was 44 months (range, 6-120 months). Seven patients had benign disease. Four cases were pleomorphic adenoma, and the remaining 3 benign cases were parotid cyst, basal cell adenoma, and hemangioma. Only 1 patient had a malignant tumor that was a lymphoepithelioma-like carcinoma. In 7 cases, wide excision (excision of mass and accessory lobe of the parotid gland) was done because of the intra-accessory parotid gland lesion. One patient had concomitant superficial parotidectomy because the tumor was located very close to and has involved the parotid gland proper. There was no serious postoperative complication and recurrence. Prudent preoperative diagnostic evaluation and meticulous surgical approach are the keys to successful management of midcheek lesions. A wide excision of the accessory lobe of the parotid gland can be a definitive surgery in case of solitary tumor with an intact parotid fascia, and wide excision with anterior approach through a standard parotidectomy incision is preferred to a direct incision over the mass.     

127例腮腺肿瘤临床治疗分析

目的:对127例腮腺肿瘤诊断和临床治疗方法进行总结分析,得出提高治愈率的经验.方法:总结本院口腔科1989～2009年收治的127例腮腺肿瘤病例资料并病理分类、手术方式、临床治愈率、术后复发率及并发症情况.结果:本组病例良性肿瘤101例、恶性肿瘤26例.所有病例均行手术治疗,部分恶性肿瘤术后辅助放疗.123例治愈,1例...     

涎腺造影曲面体层法对腮腺肿瘤的诊断价值

涎腺造影曲面体层法作为一个新的诊断方法已步入涎腺肿瘤的诊断之中．作者对33例腰腺肿瘤患者用该法检查，结果总结如下：(1)良性肿瘤的诊断：在全部28例腰腺良性肿瘤中，发现有25例的造影片上出现明显的腺泡内充盈缺损区及导管移位．周界轮廓清晰可见．(2)恶性肿瘤的诊断：在此造影片中均可见，腺体分支导管断裂、造影剂不同程度地外漏，此外还可见肿瘤的大致范围。因此本法在涎腺肿瘤的诊断中有其独特的优点，尤其是根据腺内导管的形态和腺泡的情况，在一定程度上可提示肿瘤的性质。     

Parotid gland tumors in a Korean population

Salivary gland tumors occur in about 3% of the head and neck tumors, and among the salivary gland tumors, parotid gland tumor occurs in about 80%. Because of its low frequency and small cases, it is hard to establish the epidemiologic characteristics of the tumors. This study was performed retrospectively from February 1987 to August 2010. There were 95 male, and 76 female patients. Most of the patients complained of the painless and progressively enlarged mass in the preauricular area. Peak incidence of benign parotid gland tumor was at the fifth decade of life. In the malignant tumors, peak age in males was the eighth decade, and peak age in females was from the third to the fifth decade of life, which was relatively younger and has a broad range of spectrum. Pleomorphic adenoma was the most common benign tumor of the 93 cases (61.6%) followed by Warthin tumor, occurring in 20 cases (13.2%). Squamous cell carcinoma, reported in 6 cases (30%), is the most frequent. Mucoepidermoid carcinoma was the second leading tumor. In conclusion, parotid gland tumor incidence was found to be higher in males. Pleomorphic adenoma was the most commonly encountered type of parotid gland neoplasms, which is in agreement with findings from all of the published literature from all over world. In contrast to most of the previous studies, squamous cell carcinoma was the most frequent malignant tumor found. Based on the data in this study, it has significant clinical respect and is helpful in the management of parotid gland tumors in Orientals.     

31例青少年腮腺肿瘤临床和病理分析

目的 探讨青少年腮腺肿瘤的临床和病理特点,为其治疗提供临床证据. 方法 对31例10~19岁青少年腮腺肿瘤患者的临床和病理资料进行回顾性分析,并将其与同期收治的516例成人腮腺肿瘤患者的临床特点和组织病理类型加以比较. 结果 青少年腮腺肿瘤中恶性肿瘤比例高达38. 7%(12/31),但在成人仅占17. 0%(88/516). 31例青少年腮腺肿瘤中,良性肿瘤19 例,占61. 3%,其中以多形性腺瘤居多,占良性肿瘤的89. 5%(17/19);恶性肿瘤中以黏液表皮样癌居多,占恶性肿瘤的41. 7%(5/12). 31例肿瘤患者均接受手术治疗,其中2例恶性肿瘤术后放疗. 结论 青少年腮腺肿瘤的肿瘤病理类型与成人有明显不同,应当引起重视. 对于青少年腮腺肿瘤,应重视手术治疗的早期性和彻底性.     

Epithelial salivary gland tumors of children and adolescents in west China population: a clinicopathologic study of 79 cases

Objective:  Determine the clinical and histopathologic features of epithelial salivary gland tumors of children and adolescents.
Methods:  A total of 79 cases of epithelial salivary gland tumors of children and adolescents were retrieved from the files. Information about demographic, clinical, histopathologic characteristics, and follow-up status were analyzed.
Results:  Sixty tumors (75.9%) were benign and 19 (24.1%) malignant. The most common tumor overall was pleomorphic adenoma (PA). The parotid was the most frequently involved site (43.0%). PA was the most common type of benign tumor. The most common malignant tumor was mucoepidermoid carcinoma. Five patients with parotid PA and two cases with palate myoepithelioma showed local recurrences. One patient with mucoepidermoid carcinoma showed local recurrences and died from the tumor 3 years after the initial treatment. One patient with adenocarcinoma presented local and neck recurrences, and died 4 years after initial treatment.
Conclusions:  Our data showed that the salivary gland tumors in children and adolescents may be the higher incidence of benign tumors, especially of PA; the slightly higher tendency for female predominance; the higher incidence of parotid glands. Mucoepidermoid carcinoma was the most common malignant tumor, with majority of low grade. Initial treatment should be planned to excise the tumor completely with satisfactory margins. The neck dissections or postoperative radiotherapy were performed in patients with low differentiation malignancies, or patients who present nodal metastasis or with clinically suspicious regional metastasis.