上颌窦腺样囊性癌14例临床分析

目的：探讨上颌窦腺样囊性癌(ACC)的诊断及手术加术后放疗的治疗效果，并分析与预后有关的因素。方法：回顾性分析1992～1999年14例上颌窦ACC患者的临床资料，用Kaplan-Meier法计算5年及10年无瘤生存率。结果：随访3～10年，平均67．2个月。T2N0M0 2例，健在，无复发及转移；T3N0M0 4例，其中1例术后57个月复发，3例健在，无复发及转移；T4N0M0 8例，其中2例术后分别于36个月、40个月因局部复发、颅内侵犯死亡，1例术后39个月复发，1例术后96个月全身转移，4例健在，无复发及转移。5年无瘤生存率为72．5％，10年无瘤生存率为54．4％。结论：上颌窦ACC早期症状不典型，容易误诊和漏诊；彻底的手术切除加术后放疗可以降低术后复发的机会，提高治愈率。肿瘤临床分期及手术切缘情况与预后有关。

Adenoid cystic carcinoma of the maxillary sinuses

Objective:To investigate characteristic clinical features and outcomes for patients with adenoid cystic carcinoma of the maxillary sinuses (ACC).Method:Thirteen patients with ACC were treated with a combination of surgery and radiation. Prognostic factors were retrospectively analyzed. Result:The most frequent cause of failure was local recurrence at the primary site. There was no neck node failure. 1 patient experienced distant metastases after the treatment. The overall disease free survival rate at 5 years and 10 years were 72.5 % and 54.4 %, respectively.Conclusion:The symptoms of the ACC occurred in the maxillary sinuses are not specific. The early diagnoses are usually difficult. Surgeries combined with postoperative radiation are recommended for optimal local control and survival. The prognostic factors include the clinic stages of the tumor and the resection margins.