外耳道腺样囊性癌的远处转移及预后分析

doi:10.6040/j.issn.1673-3770.0.2020.087

摘要/Abstract

摘要： 目的探讨外耳道腺样囊性癌远处转移的相关危险因素及其对预后的影响。方法回顾性分析22例江苏省人民医院2007年6月至2019年3月行原发灶根治手术且病理确诊为外耳道腺样囊性癌患者的临床和随访信息,单因素及多因素回归分析远处转移的危险因素及其对预后的影响。结果患者远处转移率为40.9%,其中肺转移发生率最高,达66.7%。单因素分析显示手术切缘阳性以及淋巴结转移与外耳道腺样囊性癌远处转移有关(P<0.05);多因素回归分析显示手术切缘阳性以及淋巴结转移与该肿瘤远处转移显著相关(P<0.05)。发生远处转移的外耳道腺样囊性癌患者5年和10年总生存率分别为44.4%、16.7%,无远处转移患者5年和10年总生存率分别为100%、100%,差异有统计学意义(P<0.05)。结论外耳道腺样囊性癌存在较高比率的远处转移,其中以肺转移为主。手术切缘阳性以及淋巴结转移是该肿瘤远处转移的独立危险因素,而远处转移则是影响该病患者预后的重要指标。

关键词: 腺样囊性癌, 外耳道, 远处转移, 预后

Abstract: Objective This study aimed to investigate the risk factors of distant metastasis of adenoid cystic carcinoma of the external auditory canal and its influence on prognosis. Methods We performed a retrospective analysis of the clinical data and follow-up information of 22 patients who underwent radical surgeries and were diagnosed with adenoid cystic carcinoma of the external auditory canal by pathology. They were admitted to the First Affiliated Hospital of Nanjing Medical University from June 2007 to March 2019. The risk factors of distant metastasis and their influence on prognosis were analyzed by univariate and multivariate analyses. Results The rate of distant metastasis in this group was 40.9%, and the incidence of lung metastasis was the highest(66.7%). Univariate analysis showed that positive surgical margin and lymphatic metastasis during the operation were related to distant metastasis of adenoid cystic carcinoma of external auditory canal(P<0.05). Multivariate regression analysis showed that positive surgical margin and lymphatic metastasis were significantly associated with distant metastasis(P<0.05). The 5-year and 10-year overall survival rates of patients with adenoid cystic carcinoma of the external auditory canal who developed distant metastasis were 44.4% and 16.7%, respectively, while those without distant metastasis had 100% 5-year and 10-year survival rates. The difference was statistically significant(P<0.05). Conclusion Adenoid cystic carcinoma of the external auditory canal has a higher rate of distant metastasis, with predominant lung metastasis. Positive surgical margin and lymphatic metastasis were were independent risk factors for distant metastasis, which is an important indicator affecting the prognosis of patients with the tumor.

Key words: Adenoid cystic carcinoma, External auditory canal, Distant metastasis, Prognosis

中图分类号:

R739.61

王莹莹,周涵,董伟达,邢光前,陈智斌,张清照,张立庆. 外耳道腺样囊性癌的远处转移及预后分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 1-6.

WANG Yingying, ZHOU Han, DONG Weida, XING Guangqian, CHEN Zhibin, ZHANG Qingzhao, ZHANG Liqing. Analysis of distant metastasis and prognosis of adenoid cystic carcinoma of the external auditory canal[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 1-6.

参考文献

[1] International Head and Neck Scientific Group. Cervical lymph node metastasis in adenoid cystic carcinoma of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal: a collective international review[J]. J Laryngol Otol, 2016, 130(12): 1093-1097. doi:10.1017/s0022215116009373.
[2] Lee BJ, Bae SC, Lee JH, et al. A case of basal cell carcinoma of external auditory canal[J]. Korean J Audiol, 2012, 16(2): 91. doi:10.7874/kja.2012.16.2.91.
[3] Amit M, Na'ara S, Trejo-Leider L, et al. Defining the surgical margins of adenoid cystic carcinoma and their impact on outcome: an international collaborative study[J]. Head Neck, 2017, 39(5): 1008-1014. doi:10.1002/hed.24740.
[4] Unsal AA, Chung SY, Zhou AH, et al. Sinonasal adenoid cystic carcinoma: a population-based analysis of 694 cases[J]. Int Forum Allergy Rhinol, 2017, 7(3): 312-320. doi:10.1002/alr.21875.
[5] Subramaniam T, Lennon P, O'Neill JP. Ongoing challenges in the treatment of adenoid cystic carcinoma of the head and neck[J]. Ir J Med Sci, 2015, 184(3): 583-590. doi:10.1007/s11845-015-1298-1.
[6] Zhang Yibo, Liu Hongyan, Wu Qianru, et al. Predictors of distant metastasis and survival in adenoid cystic carcinoma of the external auditory canal[J]. Otol Neurotol, 2019, 40(10):e1006-e1011. doi: 10.1097/MAO.0000000000002391.
[7] Bonaparte JP, Trites J, Hart R, et al. Survival when treating adenoid cystic carcinoma of the external auditory canal: Quantitative assessment of case reports[J]. Journal of Otolaryngology-Head and Neck Surgery, 2009, 38(4): 468-476.
[8] Amit M, Binenbaum Y, Sharma K, et al. Analysis of failure in patients with adenoid cystic carcinoma of the head and neck. An international collaborative study[J]. Head Neck, 2014, 36(7): 998-1004. doi:10.1002/hed.23405.
[9] Gao M, Hao Y, Huang MX, et al. Clinicopathological study of distant metastases of salivary adenoid cystic carcinoma[J]. Int J Oral Maxillofac Surg, 2013, 42(8): 923-928. doi:10.1016/j.ijom.2013.04.006.
[10] 高燕, 杨慧, 陈飞, 等. 外耳道腺样囊性癌的临床诊治分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(21): 1660-1664. doi:10.13201/j.issn.1001-1781.2018.21.013. GAO Yan, YANG Hui, CHEN Fei, et al. Clinical diagnosis and treatment of adenoid cystic carcinoma of the external auditory canal[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(21): 1660-1664. doi:10.13201/j.issn.1001-1781.2018.21.013.
[11] 冯剑, 周涵, 宋圣花, 等. 鼻腔鼻窦腺样囊性癌15例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 87-91. doi:10.6040/j.issn.1673-3770.0.2018.545. FENG Jian, ZHOU Han, SONG Shenghua, et al. Clinical analysis of 15 cases of adenoid cystic carcinoma in the paranasal sinuses and nasal cavity[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 87-91.doi:10.6040/j.issn.1673-3770.0.2018.545.
[12] Girelli L, Locati L, Galeone C, et al. Lung metastasectomy in adenoid cystic cancer: Is it worth it?[J]. Oral Oncol, 2017, 65: 114-118. doi:10.1016/j.oraloncology.2016.10.018.
[13] Vishnu Prasad, Vijendra SS, Raghavendra A R. Adenoid cystic carcinoma- a rare differential diagnosis for a mass in the external auditory canal[J]. J Clin Diagn Res. 2015,9(1):MD01-2. doi: 10.7860/JCDR/2015/10374.5369.
[14] Liu HY, Zhang YB, Zhang T, et al. Correlation between the pathology and clinical presentations in patients with adenoid cystic carcinoma of the external auditory canal[J]. Head Neck, 2017,39(12): 2444-2449. doi:10.1002/hed.24915.
[15] Ebelhar AE, West DS, Aouad RK. Ceruminous adenoid cystic carcinoma of external auditory canal[J]. Int Adv Otol, 2017, 13(2): 292-294. doi:10.5152/iao.2017.3929.
[16] International Head and Neck Scientific Group. Cervical lymph node metastasis in adenoid cystic carcinoma of the major salivary glands[J]. J Laryngol Otol, 2017, 131(2): 96-105. doi:10.1017/s0022215116009749.
[17] Dillon PM, Chakraborty S, Moskaluk CA, et al. Adenoid cystic carcinoma: a review of recent advances, molecular targets, and clinical trials[J]. Head Neck, 2016, 38(4): 620-627. doi:10.1002/hed.23925. doi: 10.1093/jrr/rrz010.
[18] Takuya Nagano, Ryo-Ichi Yoshimura, Mio Kojima, et al. Outcomes of radiotherapy in advanced external auditory canal cancer[J]. Journal of radiation research, 2019, 60(3):380-386.
[19] Holliday E, Bhattasali O, Kies MS, et al. Postoperative intensity-modulated proton therapy for head and neck adenoid cystic carcinoma[J]. Int J Part Ther,2016, 2(4):533-543. doi:10.14338/ijpt-15-00032.1.

相关文章 15

[1]	刘佳珲,田汝宪,李玉梅,宋西成. 构建铜死亡相关lncRNA模型评估头颈鳞状细胞癌预后[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 49-64.
[2]	缪红利,张妍春,郝琳娜,唐乐,何英楠. 活动性眼弓形虫病临床特征及预后分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 82-89.
[3]	彭中华,陈竹,袁洛花,余绍兰,马玉玲. 原发性鼻腔高级别非肠型腺癌1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 95-98.
[4]	李赞,卢奇,申卫东,侯昭晖,吴南. 坏死性外耳道炎临床诊治18例[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 17-22.
[5]	李康,李轩毅,刘稳. 慢性化脓性中耳炎合并外耳道真菌感染的诊断与治疗[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 23-30.
[6]	刘玉柱,陈尧,苑铁君,李春森,李波. 喉纤维肉瘤1例并相关文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 133-137.
[7]	黄佳丽,刘梓琪,徐娟,陈曦,张立庆,周涵. 咽部梭形细胞鳞状细胞癌的临床及预后分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 94-100.
[8]	李美辰,陈海玲,李阳,马登殿. 下鼻甲黏液囊肿1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 91-94.
[9]	杨开炎, 唐凤珠, 覃启才, 李旭祥, 冯大益, 农丰靖, 杨秋云. 异常纺锤体样小头畸形相关蛋白在鼻咽癌中的表达及其临床意义[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 18-25.
[10]	王凯健,陈雪生,王威. 血小板-淋巴细胞比值与喉鳞状细胞癌预后相关性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 67-73.
[11]	张佳佳,石安妮,邢御,洪玉颖,白鹏. 针刺联合西药治疗全聋型突发性聋1例与文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 88-92.
[12]	索安奇,孙聚兴,牛红燕,周艳秋,牛鹏昊,毛文伟,李晓瑜,杨欣欣. 耳部钢筋复杂穿刺伤救治1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 79-83.
[13]	邵永良,周鲲鹏,李广盛,张学梅,杨泽垠. 耳后径路取带蒂皮瓣修复外耳道皮肤缺损18例[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 1-5.
[14]	张永红,张辉,王彩华,杨欣欣,吴允刚,赵玉凤,庞太忠,李晓瑜. 基于TCGA数据库构建喉鳞状细胞癌免疫相关基因预后模型及筛选靶向分子药物[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 54-62.
[15]	郝红,陈钢,王林娥. 腺样囊性癌关键基因表达的生物信息学分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 99-106.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed