原发性腮腺鳞状细胞癌的临床分析

目的回顾性总结分析19例原发性腮腺鳞癌的临床特点、预后的相关因素及治疗策略。方法总结分析1993年3月至2004年2月间收治并经组织病理学证实的原发性腮腺鳞癌19例的临床资料,采用Fisher确切概率法进行分析。结果全组患者在病程中出现颈淋巴转移的概率为68.42%（13/19）,全组3、5年生存率为47.36%和42.10%,无瘤生存7例,带瘤生存1例。术后随访的死亡者中,局部复发6例,颈淋巴转移复发2例,合并有局部复发和颈转移2例,远处肺转移1例。单因素分析仅显示N分期对生存率有影响;而T分期、手术范围、术后病理和是否有血管神经侵犯等对生存率的影响没有统计学意义,究其原因推测与样本含量较小有关。结论原发性腮腺鳞癌的局部复发率和颈淋巴转移率均很高,应用广泛性手术及术后放射治疗是首选的最佳综合治疗方案。

The clinical analysis of constitutional parotid gland squamous cell carcinoma

Objective To investigate the clinical characteristics、prognosis of related factors and treatment of primary parotid squamous cell cacinoma through 19 patients.Methods 19 such patients treated in our hospital from 1993 to 2004 were analyzed retrospectively by using Fisher exact probability method.Results The overall neck metastastic lymph nodes was observed in 13 patients(68.42%).The 3 and 5-year survival for the whole group was 47.36% and 42.10% respectively including 7cases of disease-free survival and 1 case was disease survival.There were 6 cases of local recurrence,2 cases of risk of neck node metastasis recurrence,2 cases of local recurrence and risk of neck node metastasis recurrence,and 1 case of distant metastasic of lung for the following uppost operation death.Single element analysis showed that just N staging has influence about the survival rate of patients;The factor includes T staging、the extent of the procedure、pathological and whether infringement of nervus vascularis ect for the survival rate of patients has not statistically significant,The reason for the problem maybe the sample size is very less.Conclusion The primary parotid squamous cell carcinoma has high risk of neck node metastasis and high local recurrence rates,the best choice of suitable treatment for it is wide surgery plus aftertreatment postoperative radiotherapy.