Indicators for Malignant Transformation in Patients With Lymphoepithelial Lesion
Indicators for Malignant Transformation in Patients With Lymphoepithelial Lesion
复制标题
淋巴上皮病变患者恶变指标
DOI：
10.1016/j.joms.2020.09.046
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发表时间：
2021-03-29
影响因子：
1.9
通讯作者：
Li, Jiang
中科院分区：
文献类型：
--
作者：
Gu, Ting;Zhang, Chunye;Li, Jiang
目的：涎腺病变是一种独特的疾病，部分患者可发生恶变。本研究的目的是估计恶性转化的频率和恶性成分的亚型，并确定与恶性转化和恶性成分的亚型与LEL.Patients和方法的患者相关的因素：本研究是基于2005年和2017年之间的回顾性队列研究，从患者被诊断为LEL。预测变量由一组变量组成，这些变量分为人口统计学、临床和病理特征。结果变量是恶性转化状态和恶性成分的亚型。结果：252例LEL患者的临床资料均经χ 2检验和Logistic回归分析（包括有或无恶性转化），平均年龄为50.3岁; 58例（58/252; 23.0%）为男性，194例（194/252; 77.0%）为女性。腮腺是LEL最常见的部位（206/252; 81.7%），36.5%（92/252）的患者有干燥综合征（SS）病史。直径大于2cm的肿块有恶变的证据（P <0.001）。与恶性成分亚型相关的因素是SS病史（P <0.001）和EB病毒感染。粘膜相关淋巴组织淋巴结边缘区淋巴瘤的非恶性转化率（MALT淋巴瘤）和LEL进展为淋巴上皮癌的比例为44.8（113/252），47.6（252人中的120人），7.6%结论：MALT淋巴瘤是最常见的恶性亚型，其恶变率超过半数。较大的肿块（>2 cm）是LEL患者恶变的独立指标。LEL患者的SS病史被认为是MALT淋巴瘤的危险因素。(C)2020年美国口腔颌面外科医师协会
Purpose: Salivary lesion (LEL) represents a unique disease, and some patients have malignant transformations. The study aims were to estimate the frequency of malignant transformation and the subtype of the malignant component and to identify factors associated with malignant transformation and subtype of the malignant component in patients with LEL.Patients and Methods: This study was based on a retrospective cohort study between 2005 and 2017 from patients who were diagnosed as LEL. The predictor variable was composed of a set of variables grouped into demographic, clinical, and pathologic features. The outcome variables were malignant transformation status and subtype of the malignant components. All parameters between the predictor variables and outcome variables were analyzed using the chi(2) test and a logistic regression model.Results: The sample was composed of 252 cases of LEL (including with or without malignant transformation) with a mean age of 50.3 years; 58 (58 of 252; 23.0%) were males, 194 (194 of 252; 77.0%) were females. The parotid gland was the most common site of LEL (206 of 252; 81.7%), and 36.5% (92 of 252) of the patients had a history of Sjogren syndrome (SS). Masses greater than 2 cm in diameter had evidence of malignant transformation (P < .001). Factors associated with the subtype of malignant components were a history of SS (P < .001) and Epstein-Barr virus infection. The percentages of nonmalignant transformations, LEL with extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma), and LEL progressing to lymphoepithelial carcinoma were 44.8 (113 of 252), 47.6 (120 of 252), and 7.6% (19 of 252), respectively.Conclusions: More than half of cases have a malignant transformation, and MALT lymphoma is the most common malignant subtype. A larger mass (>2 cm) is an independent indicator of malignant transformation in LEL patients. History of SS among LEL patients is considered a risk factor for MALT lymphoma. (C) 2020 American Association of Oral and Maxillofacial Surgeons