口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (6): 400-405.doi: 10.12016/j.issn.2096-1456.2021.06.007

• 临床研究 • 上一篇    下一篇

腮腺淋巴上皮癌22例临床分析

张曙光1(),尹西腾2,徐文光2,韩伟2,刘喆2()   

  1. 1.淮安肿瘤医院口腔科,江苏 淮安(223001)
    2.南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,江苏 南京(210008)
  • 收稿日期:2021-01-05 修回日期:2021-01-31 出版日期:2021-06-20 发布日期:2021-04-12
  • 通讯作者: 刘喆 E-mail:315725513@qq.com;kqliuzhe@163.com
  • 作者简介:张曙光,副主任医师,硕士,Email: 315725513@qq.com

Clinical analysis of 22 cases of lymphoepithelial carcinoma of parotid gland

ZHANG Shuguang1(),YIN Xiteng2,XU Wenguang2,HAN Wei2,LIU Zhe2()   

  1. 1. Department of Stomatology, Huaian Tumor Hospital, Huai’an 223001, China
    2. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2021-01-05 Revised:2021-01-31 Online:2021-06-20 Published:2021-04-12
  • Contact: Zhe LIU E-mail:315725513@qq.com;kqliuzhe@163.com

摘要:

目的 探讨腮腺淋巴上皮癌的诊断方法、治疗方式及预后情况,为临床提供参考。方法 2012年至2019年期间收治的腮腺淋巴上皮癌病例22例,对患者的临床表现、影像学检查、治疗方式及随访结果进行回顾性分析。结果 22例患者中,男性8例,女性14例;年龄26~61岁,主诉病程3天~18年,单侧腮腺区多发肿块1例,其余21例均为腮腺区单侧单发肿块。所有患者均行术前螺旋CT检查,CT所示腮腺组织内软组织肿块影,其内密度影欠均匀,CT值26~81 HU,15例表现为类圆形,界限尚清晰;7例表现为结节状,界限稍不清晰或部分不清晰。所有病例诊断最终依据病理学检查,HE染色图像可见肿瘤细胞边界清楚,上皮细胞生长活跃伴有异型性,可见核分裂像,肿瘤间质可见丰富的淋巴细胞浸润。22例患者均接受手术治疗,其中9例患者未行颈淋巴清扫。20例患者术后接受辅助放疗,其中10例同时行辅助化疗;1例患者术后仅行化疗,1例患者术后未行其他任何辅助治疗。所有病例均得到回访,21例无瘤生存13个月~8年,1例患者术后16个月因肝转移死亡。结论 腮腺淋巴上皮癌是临床上较为罕见的恶性肿瘤,病理仍是诊断腮腺淋巴上皮癌的金标准。根治性手术切除肿瘤是首选治疗方法,根据临床检查及影像学检查及颈部情况进行选择性颈淋巴清扫,术后辅助放化疗可获得较好的治疗效果。

关键词: 淋巴上皮癌; 腮腺; 腮腺切除术; 面神经解剖术; 颈淋巴清扫; 放疗; 化疗

Abstract:

Objective To investigate the diagnosis, treatment and prognosis of lymphoepithelial carcinoma of the parotid gland. Methods Data from 22 patients with parotid lymphoepithelial carcinoma from 2012 to 2019 were collected, and their clinical manifestations, imaging examinations, treatment methods and follow-up results were retrospectively analyzed. Results Among the 22 patients, 8 were males and 14 were females. The patients ranged from 26 to 61 years old, with a complaint duration ranging from 3 days to 18 years. One patient had multiple unilateral lumps in the parotid gland, and the other 21 patients had single unilateral lumps in the parotid gland. All patients underwent preoperative spiral CT examination. CT showed a soft tissue lump in the parotid tissue, the internal density shadow was not uniform, the CT value ranged from 26 to 81 Hu, and 15 patients presented elliptical lesions with clear boundaries. Seven patients presented nodular lesions, and the boundary was not clear. The diagnosis of all cases was ultimately based on pathological examination. Hematoxylin-eosin (HE) staining images showed active epithelial cell growth with atypia, mitotic figures could be seen, and abundant lymphocyte and plasma cell infiltration could be seen in the tumor stroma. All 22 patients received surgical treatment; 9 patients did not undergo cervical lymph node dissection. Twenty patients received adjuvant radiotherapy after surgery, and 10 of them received adjuvant chemotherapy at the same time. One patient only received chemotherapy after surgery, and one patient did not receive any other adjuvant therapy after surgery. All patients received follow-up visits. One patient died of liver metastasis 16 months after the operation, and the remaining patients survived without tumors for periods of 13 months to 8 years until the present. Conclusion Parotid lymphoepithelial carcinoma is a rare malignant tumor clinically. Pathology is still the gold standard for the diagnosis of lymphoepithelial carcinoma of the parotid gland. Radical resection of the tumor is the first choice of treatment. Selective neck lymph node dissection and postoperative adjuvant radiotherapy and chemotherapy can obtain better therapeutic effects according to clinical examination, imaging examination and neck conditions.

Key words: lymphoepithelial carcinoma; parotid gland; parotidectomy; facial nerve anatomy; neck lymphatic dissection; radiotherapy; chemotherapy

中图分类号: 

  • R78