头颈肌上皮癌的生物学特征及诊疗分析

目的探讨头颈肌上皮癌的临床表现，病理、免疫组化特点及诊疗方法，提高对该病的诊疗水平。方法回顾性分析经病理确诊的5例头颈肌上皮癌患者的临床资料，结合文献并从生物学、诊疗和预后方面进行分析。结果5例患者均经病理和免疫组化确诊，其中腮腺3例，硬腭1例，鼻、鼻窦1例。5例患者行根治性手术治疗4例，1例放弃手术而行放、化疗。3例术后局部复发，其中2例出现颈淋巴结转移，行二次手术或加颈淋巴结清扫术，2例出现远处转移；至末次随访，4例死亡，1例无瘤生存（术后10个月）。结论头颈肌上皮癌是预后极差的上皮性恶性肿瘤，好发于腮腺，鼻、鼻窦者极为罕见；颈淋巴结和远处转移率较高，治疗采用手术为主的综合治疗，术后复发率高。

Diagnosis,treatment and biocharacteristics of myoepithelial Carcinoma in head and neck.

Objective To explore the clinical, histopathologic and immunohistochemical features and the methods of di- agnosis and treatment of myoepithelial Carcinoma in head and neck. Methods A retrospective study was carried out in 5 cases of myoepithelial carcinoma in head and neck from January 2003 to December 2012. With literature review, the clinical, histopathologic and immunohistochemistic characteristics of this disease were discussed. Results There were 3 cases originated in parotid gland, 1 case in hard palate, and 1 in nasal cavity and nasal sinus. All cases were diag- nosed by pathohistological and immunohistochemical findings. 4 cases underwent radical surgery, while 1 case received radio-chemotherapy. After the operation, local recurrenceoccurred in 3 cases, in which 2 cases of cervical lymph node metastasis underwent secondary neck dissection, while distance metastasis was identified in 2 cases. During the follow- up, four patients died of tumor , and 1 patient was tumor-free survival（ 10 months after operation）. Conclusion Myo- epithelial carcinoma in head and neck is a malignant epithelial tumor with poor prognosis, which mostly occurs in the salivary glands, rarely in nasal cavity and nasal sinus, with high occurrence of cervical lymph nodes and/or distance metastasis. Comprehensive treatment is recommned, however, postoperative recurrence is still common.