| 王佳峰,谭 卓,邵 岚.涎腺腺样囊性癌远处转移规律及其影响因素分析[J].肿瘤学杂志,2017,23(4):290-294. |
| 涎腺腺样囊性癌远处转移规律及其影响因素分析 |
| Distant Metastasis Pattern and Related Risk Factors of Salivary Adenoid Cystic Carcinoma |
| 投稿时间：2017-02-05 |
| DOI：10.11735/j.issn.1671-170X.2017.04.B008 |
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| 中文关键词: 涎腺 腺样囊性癌 远处转移 化疗 |
| 英文关键词:salivary gland adenoid cystic carcinoma distant metastasis chemotherapy |
| 基金项目:浙江省自然科学基金（LY14H160014） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨涎腺腺样囊性癌（salivary adenoid cystic carcinoma，SACC）远处转移的影响因素及其对预后的影响，为其合理治疗提供依据。［方法］ 回顾性分析122例SACC的临床和随访资料，分析远处转移的影响因素。计数资料采用χ2检验或精确概率法，Kaplan-Meier法计算生存率，组间比较采用Log-rank对数秩检验，Cox比例风险模型进行多因素分析。［结果］ 中位随访时间86个月，随访过程中36例（29.5%）发现远处转移，其中31例（86.1%）出现肺转移。单因素分析显示临床分期、淋巴结转移、切缘状况和病理分级是远处转移的影响因素（P<0.05）。Cox模型多变量分析显示淋巴结转移和阳性切缘是SACC无远处转移生存时间的独立影响因素（P<0.05）。有远处转移SACC的5、10年生存率分别为61.1%、23.4%，无远处转移SACC的5、10年生存率分别为84.9%、68.9%，差异有统计学意义（P<0.001）。接受了化疗的远处转移SACC患者的 5、10年生存率分别为72.7%、38.8%，而未接受后续化疗的远处转移SACC患者的5、10年生存率分别为56.0%、18.4%，但差异无统计学意义（P=0.213）。［结论］ SACC容易发生远处转移，尤其是肺转移，其中淋巴结转移和阳性切缘是SACC发生远处转移重要的风险因素。远处转移SACC缺乏有效治疗手段，预后较差，化疗并不能改善其预后。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the risk factors of distant metastasis in patients with salivary adenoid cystic carcinoma(SACC) and their influence on prognosis，providing a reference for treatment. ［Methods］ Clinical and follow-up data of 122 patients with SACC were reviewed. Continuous variables were analyzed using χ2 test or Fisher’s exact test. Patient survival was analyzed using Kaplan-Meier method. Log-rank test was used for intergroup comparison，and Cox proportional hazards model for multivariate analysis. ［Results］ The median follow-up duration was 86 months. Distant metastasis occurred in 36(29.5%) patients，including lung metastasis in 31(86.1%) patients. Univariate analysis showed that clinical stage，lymph node metastasis，pathological grade，and surgical margin status were significantly associated with distant metastasis of SACC(all P< 0.05). Cox model multivariate analysis showed that lymph node metastasis and positive margin were independent risk factors of the distant metastasis-free survival of SACC patients. The 5- and 10-year overall survival(OS) rates were significantly lower in patients with distant metastasis than in patients without distant metastasis(5-year OS rate： 61.1% vs. 84.9%，P<0.001；10-year OS rate： 23.4% vs. 68.9%，). Among patients with distant disease，the 5- and 10-year survival rates were similar between patients treated with and without chemotherapy(P=0.213). ［Conclusions］ SACC patients are prone to distant metastasis，especially lung metastasis. Lymph node metastasis and positive surgical margin are important risk factors for distant metastasis. The prognosis of SACC with distant disease is poor. No effective treatment，such as chemotherapy，is available for this disease to date. |
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