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。

Analysis on the Diagnosis of Masses in the Parotid Gland Area

Objective: To improve the diagnosis level of masses in the parotid gland area.Methods: A retrospective analysis on 296 cases of masses in the parotid gland area from 2005~2010 was carried out,involving the general data,proportion of incidence,clinical presentation,and diagnosis methods.Results: The male∶female ratio of masses in the parotid gland area was 1.19∶1,and the age of onset was from 1 year old to 83 years old.Pleomorphic adenoma were 80 cases,accounting for 27% of parotid gland masses and 50% of benign tumor in parotid gland area,respectively.Warthin tumor were 50 cases,16.9% and 31.3% respectively.Inflammatory mass were 27 cases,accounting for 9.1% of masses in the parotid gland area.Mucoepidermoid carcinoma were 14 cases,accounting for 4.7% of parotid gland masses and 29.2% of malignant tumor in the parotid gland area,respectively.Adenoid cystic carcinoma and carcinoma in pleomorphic adenoma were both 7 cases,accounting for 2.4% and 14.6% respectively.Branchial cyst were 6 cases,accounting for 2.0% of masses in the parotid gland area.The incidence rate of pleomorphic adenoma in the fifth and sixth decade was the highest among that of all age groups,the incidence rate of Warthin tumor in the sixth,seventh and eighth decade was the highest,and the incidence rate of inflammatory mass in the seventh decade was the highest(chi-square test,P<0.005).Conclusion: Masses in the parotid gland area cover diverse diseases with multiple presentations.An overall consideration of various factors,such as clinical manifestations,B-Mode ultrasonography,CT or MRI,fine needle aspiration cytology,and intraoperative frozen section,can provide important help for the diagnosis and treatment of masses in the parotid gland area.