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1、气管、支气管唾液腺型癌外科治疗龙谦梅宏许川张庆斌孙永攀刘波刘迪韩连奎胡剑罗猛(通讯作者)［摘要］背景与目的：原发性气管、支气管唾液腺型癌是一类低度恶性肿瘤,伍括粘液表皮样癌、腺样囊性癌、上皮-肌皮样癌。临床报道相对较少，木文回顾分析单中心外科治疗该类肿瘤临床病理特征及预后。方法：收集2002年12月至2013年6月于贵州省人民医院胸外科接受外科手术治疗的42例唾液腺型癌患者资料，并随访，分析其临床病理特点及预后影响因素。结果：木组中粘液表皮样癌28例，腺样囊性癌14例，无上皮-肌皮样癌。腺样囊性癌位于气管或主支气管者更多(P<0.05)。全组随访11-139月，平均57.2月。全组5年
2、无复发生存率及总体生存率分别为62.6%和76.6%。单因素分析显示，伴淋巴结转移者(无论是N1阳性还是N2阳性)更易复发且总体生存率更差(P<0.05)；多因素分析结果显示，伴有纵隔淋巴结转移是患者不良预后的独立影响因素。结论：对于气管、支气管唾液腺型癌，手术切除是首选治疗措施，能取得良好疗效。纵隔淋巴结转移是该类肿瘤不良预后的独立影响因素。［关键词］唾液腺型癌气管支气管外科手术治疗D0l:10.3760/cma.j.issn.0376-2491.2015.28.21作者单位：550002,贵州省贵阳市，贵州市人民医院胸外科SurgicalTreatmentofTrachealand
3、BronchialSalivaryGland-typeCarcinomaLongQian,MeiHong,XuChuan,ZhangQingbin,SunYongpan,LiuBo,LiuDi,HanLiankui,HuJian,LuoMengAbstract:ObjectivePrimarysalivarygland-typecarcinomasoftracheaandbronchiareraretumorsthatincludemucoepidermoidcarcinoma(MEC),adenoidcysticcarcinoma(ACC),andepithelial-myoepit
4、helialcarcinoma(EMC).Theyarelowmalignantneoplasmswithdistinctclinicopathologicalfeaturesandprognosis.Reportsonthemwerelittle.Therefore,thispaperaimstoretrospectivelyanalyzetheclinicopathologicprofilesofthiscarcinomaandpatientslong-termprognosisaftersurgicalresection.MethodsClinicaldataof42patien
5、tswithsalivary-typecarcinomasintheDepartmentofThoracicSurgery,GuizhouProvincialPeople’sHospitalfromDecember2002toJune2013wereretrospectivelyselectedandanalyzed.Follow-upwasconductedtoeachpatient.Theclinicopathologicprofilesandfactorsinfluencingthelong-termprognosiswereanalyzed.ResultsThere
6、were28casesofMECand14casesofACCwhilenoEMCwaspresented.ComparedwithMEC,moreACCwerelocatedattracheaormainstembronchi(P<0.05).Themeanperiodoffollow-upwas57.2months,rangefrom11to139months.The5-yearrecurrence-freesurvival(RFS)andoverallsurvival(OS)were62.6%and76.6%,respectively.Univariantanalysisshow
7、edthatpatientswithlymphnodemetastases(N1orN2)hadhigherpotentialityofrecurrenceandworselong-termprognosis(P<0.05).Multivariantanalysisshowedthatmediastinallymphnodemetastasis(N2)wasanindependentfactorofpoorprognosis.Conclusio
