不同类型腮腺肿瘤的临床特点及远期复发情况分析

目的 探究不同类型腮腺肿瘤的临床特点及远期复发情况。 方法 对2011年3月—2015年12月间于温岭市第一人民医院就诊的157例原发性腮腺肿瘤患者进行回顾性分析，所有患者均进行肿瘤切除术，术中肿块组织冰冻切片送病理检查，比较不同类型患者的临床资料、术后并发症发生率以及术后复发情况，并应用Cox回归模型分析复发危险因素。 结果 共检出良性肿瘤142例，其中，多形性腺瘤(pleomorphic adenoma，PA)和腺淋巴瘤(Warthin’s tumor，WT)的构成比较高(63.06%和24.21%)；恶性肿瘤共15例。恶性肿瘤和WT患者的年龄均显著高于PA患者(均P<0.05)；WT患者的男性比例、吸烟者比例、双侧发病比例、吸烟指数和肿块直径均显著高于PA和恶性肿瘤患者(均P<0.05)。恶性肿瘤和WT患者术后并发症发生率高于PA患者(P<0.05)。在28～60个月的随访过程中，5例WT患者和11例恶性肿瘤患者发生复发，PA患者未发生复发，WT患者的复发风险显著低于恶性肿瘤患者(HR=0.132，P<0.001)；Cox回归显示，术后吸烟是WT患者复发的独立危险因素(HR=2.794，P<0.001)。 结论 PA和WT是最常见的原发性腮腺肿瘤类型，WT的发病年龄、男性与双侧发病比例和吸烟指数较高，WT和恶性肿瘤患者具有较高的术后并发症发生率，术后吸烟是WT复发的危险因素。 

Analysis of clinical characteristics and long-term recurrence of different types of parotid tumors

Objective To analyze the clinical characteristics and long-term recurrence of different types of parotid tumors. Methods A retrospective analysis of 157 patients with primary parotid tumors treated in our hospital from March 2011 to December 2015 was performed. All patients were taken tumor resection, intraoperative frozen tissue biopsy sent to pathological examination. The clinical data of different types of patients were compared, the incidence of postoperative complications and postoperative recurrence, and Cox regression model was used to analyze the risk factors of relapse. Results A total of 142 benign tumors were detected, of which, pleomorphic adenoma (PA) and Warthin's tumor (WT) were relatively high (63.06% and 24.20%). There were 15 malignant tumors were detected. Malignant and WT patients were both significantly higher than patients with PA in age (all P<0.05). The proportion of smoking, the index of smoking and the diameter of tumor were significantly higher than those in patients with PA and malignant tumor (all P<0.05). The incidence of postoperative complications in patients with malignant tumors and WT was higher than patients with PA. During 28 to 60 months of follow-up, 10 patients with WT and 11 patients with malignant tumor developed recurrence without relapse in patients with PA, and the risk of recurrence in patients with WT was significantly lower than that in patients with malignancy [HR=0.132, 95% CI (0.041, 0.425), P<0.001]. Cox regression showed that postoperative smoking was an independent risk factor for recurrence in patients with WT [HR=2.794, 95% CI (1.304, 9.625), P<0.001]. Conclusion PA and WT are the most common types of primary parotid tumors, of which, the age at onset, the male ratio and the smoking index of Warthin's tumor are obviously higher, and the patients with WT and malignancy have a higher incidence of postoperative complications, postoperative smoking is an independent risk factor for recurrence in patients with WT.