粘液表皮样癌128例疗效观察

摘要

Objectives: To study the treatment outcome of mucoepidermoid carcinoma(MEC).Methods:128 cases of MEC with definite pathologic diagnosis treated in our hospital during the past 15 years were investigated. The relationship between the effects of the therapy and the prognosis was analysed.Result:Treatment with surgical operation only was used in 99 cases,radiotherapy after operation was applied in 26 cases and follow-up was carried out in 76 cases. 5-year survival rate was 90.7%.5 patients who died within 5 years after operation were all with the diagnosis of MEC in clinical stage Ⅳand poor differentiaton.Conclusion:The local extensive excision for the well differentiated MEC,the radiotherapy after operation for poorly differentiated or that of clinical stage Ⅳ,especially in maxilla,may increase 5-year survival rate.Since there were cases of recurrences of MEC 13 years after surgical treatment,long-term follow-up is necessary.%目的：分析探讨粘液表皮样癌(MEC)的治疗方法。方法：采集我院近15年来有病理诊断的MEC病例128例进行随访，根据WHO（1991）涎腺肿瘤TNM分期和临床分期标准进行重新分类，分析治疗方法与预后的关系。结果：99例单纯手术治疗（其中27例联合根治术），26例加术后放疗，3例姑息治疗。随访到的76例中按生存率法统计5年存活率为90.7%。肿瘤复发与手术切缘及临床分期明显相关，5年内死亡的5例均为临床IV期的低分化型。结论：对高分化MEC进行局部扩大切除手术、对低分化的或临床IV期的，特别是上颌的MEC进行术后放疗均可以提高5年存活率。鉴于MEC存活13年后仍有复发的病例，需要长期随访。