不同类型腮腺癌41例临床治疗的研究.docVIP

不同类型腮腺癌41例临床治疗的研究 　　[摘要]目的：探讨不同类型腮腺癌的有效治疗方法。方法：对41例腮腺癌患者的临床资料进行分析。分析各类型腮腺癌的治疗效果。结果：腮腺腺样囊性癌15例，腺泡细胞癌9例，癌在多形性腺瘤中5例，鳞状细胞癌3例，粘液表皮样癌3例，导管癌3例，未分化癌2例，低分化腺癌1例。临床分期：Ⅰ期8例、Ⅱ6期例、Ⅲ期8例，Ⅳ期19例。术前行活检19例，只行腮腺肿物+腮腺摘除23例，行同侧肩胛舌骨上淋巴清扫术18例；保留面神经18例，面神经切除23例，术后放疗22例，同时行术后放化疗2例。结果：术后复查1～5年。局部复发7例，其中腺样囊性癌2例，癌在多形性腺瘤、鳞状细胞癌、粘液表皮样癌、导管癌、未分化癌各1例；远处转移2例，均为腺样囊性癌。结论：腮腺癌如肿物恶性程度不高，无神经受损症状及术中肿物与神经无明显粘连可保留面神经；低分化粘液表皮样癌、腺癌、导管癌、未分化癌建议同期行颈淋巴清扫术，其余术前淋巴结无肿大可不作颈淋巴清扫术；腺样囊性癌、低分化粘液表皮样癌、导管癌、未分化癌建议行术后放疗。腮腺癌软组织（皮肤）修复尽可能使用邻位皮瓣修复，效果良好。 　　[关键词]腮腺癌；手术；放疗；化疗；修复 　　[中图分类号]R782 [文献标志码]A [文章编号]1008-6455（2015）18-0027-04 　　Retrospective investigate remedy for different types of parotid cancer in 41 cases 　　XIAN Dan，WANG Lei，CHEN Ju-feng，LI Jin，MO Chu-jia，LI Jie 　　（Department of Stomatology，The First Hospital of Foshan，Foshan 528000，Guangdong，China） 　　Abstract： Objective Investigate effective remedy for different types of parotid cancer. Methods Retrospective investigate clinical data and out came of different parotid cancers in 41 patients，which included 15 adenoid cystic carcinoma，9 acinar cell carcinoma，5 cancer in pleomorphic adenoma，3 squamous cell carcinoma，3 mucoepidermoid carcinoma，3 ductal carcinoma，2 undifferentiated carcinoma and 1 poorly differentiated adenocarcinoma.In all 41 cases，8 are clinical stage I，6 are clinical stage II，8 clinical stage III，19 clinical stage IV.19 cases undergo pre operation biopsy，23 undergo parotid and mass resection，18 undergo homonymy supraomohyoid neck dissection.Facial nerve was reserved in 18 cases，facial nerve was sacrificed in 23 cases.22 cases undergo post operation radiotherapy，2 undergo post operation chemoradiation. Results Follow up period extend from 1 to 5 years.7 cases had local recurrence，including each 1 of pleomorphic adenoma，squamous cell carcinoma，mucoepidermoid carcinoma，ductal carcinoma and undifferentiated carcinoma.2 cases of adenoid cystic carcinoma had metastasis. Conclusions Facial nerve can be reserved in low grade carcinoma of parotid with no facial n