山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (6): 22-25.doi: 10.6040/j.issn.1673-3770.0.2013.148

• 论著 • 上一篇    下一篇

头颈肌上皮癌的生物学特征及诊疗分析

陈志喜1,刘阳云2,周文芳1,张金平1,罗许勇1,叶雪萌1,熊奇斌1,刘火旺3   

  1. 1.汕头大学医学院附属粤北人民医院耳鼻咽喉科,广东 韶关 512026;
     2.解放军第163医院耳鼻咽喉科,长沙  410003;
     3.中南大学湘雅三医院耳鼻咽喉头颈外科,长沙  410013
  • 收稿日期:2013-05-15 发布日期:2013-12-16
  • 通讯作者: 刘火旺,博士。Email:firehot6@163.com
  • 作者简介:陈志喜。 Email:czx009135@yahoo.com.cn
  • 基金资助:

    韶关市科学计划项目(韶科卫2012CX/K163),韶关市卫生项目(Y12026)

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

CHEN Zhi-xi1, LIU Yang-yun2, ZHOU Wen-fang1, ZHANG Jin-ping1, LUO Xu-yong1, YE Xue-meng1, XIONG Qi-bin1, LIU Huo-wang3   

  1. 1.Department of Otolaryngology, Yuebei Hospital  of Shantou University Medical College, Shaoguan 512026, Guangdong,China; 2.Department of Otolaryngology, No. 163 Hospital of PLA, Changsha 410003,  China; 3. Department of Otolaryngology & Head and Neck Surgery, Third Xiangya Hospital of Central South University, Changsha 410013,  China
  • Received:2013-05-15 Published:2013-12-16

摘要:

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。

关键词: 肌上皮癌, 组织病理, 免疫组化, 生物学特征

Abstract:

Objective    To explore the clinical, histopathologic and immunohistochemical features and the methods of diagnosis 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 diagnosed 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    Myoepithelial 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.

Key words: Myoepithelial carcinoma, Clinical characteristics, Immunohistochemistry, Histopathology

中图分类号: 

  • R739.87
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