鼻腔低级别非肠型腺癌1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2022.375

摘要/Abstract

摘要： 目的探讨鼻腔低级别非肠型腺癌的临床特点及诊疗方法。方法回顾性分析1例鼻腔低级别non-ITAC患者的临床资料,并复习相关文献,总结其临床表现、诊断、治疗方法及预后。结果术后9个月随访,患者无鼻塞、脓涕及涕中带血等症状,蝶窦口及其下方可见肉芽组织。结合本例患者的临床资料, 同时回顾既往中英文数据库关于鼻腔鼻窦低级别non-ITAC的报道,共计18例;患者CK7为阳性(94.4%)、CK20为阴性(61.1%)、CDX-2为阴性(61.1%),Ki-67增殖指数1%~15%;仅予以手术治疗(77.8%),手术后辅以放疗(16.6%),先放疗后予手术切除(5.6%);患者密切随访,时间为9个月至6年,平均随访时间为35.8个月,随访患者中有10例未见复发。结论鼻腔鼻窦 non-ITAC 患者临床表现及影像学对诊断有重要意义,病理免疫学对分级、治疗方案和预后有指导作用。

关键词: 鼻腔鼻窦, 非肠型腺癌, 低级别, CK7, Ki-67

Abstract: Objective To summarize and analyze the clinical features, diagnostic methods, and treatment of low-grade non-intestinal-type adenocarcinoma(non-ITAC)within the nasal cavity. Methods The clinical data of a patient with low-grade non-intestinal-type adenocarcinoma within the nasal cavity was retrospectively analyzed with further review of relevant literature to summarize its clinical manifestations, diagnosis, treatment and prognosis. Results The patients underwent follow-up for 9 months, and had no symptoms such as nasal obstruction, purulent and/or bloody nasal discharge. Granulation tissue could be seen at and below the ostium of the sphenoid sinus. Based on the clinical data of this patient, we reviewed previous reports in the Chinese and English databases on low-grade non-ITAC within the nasal cavity, totaling 18 cases. The data showed CK7 was positive(94.4%), CK20 was negative(61.1%), CDX-2 was negative(61.1%), Ki-67 proliferation index was 1%~15%, treatment using only surgery(77.8%), postoperative adjuvant radiotherapy(16.6%), and surgery after radiotherapy(5.6%).The patients were closely followed-up for 9 months to 6 years, with an average follow-up time of 35.8 months. Ten of them had no recurrence. Conclusion The clinical and imaging features of non-ITAC of the nasal cavity and paranasal sinuses are important for diagnosis, and the pathological immunology is helpful for grading, treatment and prognosis.

Key words: Nasal cavity and paranasal sinus, Non-intestinal type adenocarcinoma, Low-grade, CK7, Ki-67

中图分类号:

R739.62

孙洁,肖旭平,李云秋. 鼻腔低级别非肠型腺癌1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 26-30.

SUN Jie, XIAO Xuping, LI Yunqiu. Low-grade non-intestinal-type adenocarcinoma in the nasal cavity: a case report and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 26-30.

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