Clinicopathologic Features and Prognostic Factors of Widely Invasive Carcinoma Ex Pleomorphic Adenoma of Parotid Gland: A Clinicopathologic Analysis of 126 Cases in a Chinese Population
Clinicopathologic Features and Prognostic Factors of Widely Invasive Carcinoma Ex Pleomorphic Adenoma of Parotid Gland: A Clinicopathologic Analysis of 126 Cases in a Chinese Population
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中国人群126例腮腺多形性腺瘤广泛侵袭性癌的临床病理特征及预后因素
DOI：
10.1016/j.joms.2020.06.013
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发表时间：
2020-12-01
影响因子：
1.9
通讯作者：
Li, Jiang
中科院分区：
文献类型：
--
作者：
Hu, Yuhua;Xia, Liang;Li, Jiang
目的：唾液腺囊内癌前多形性腺瘤 (ICCXPA) 和微创 CXPA (MICXPA) 通常具有良好的预后。相比之下，广泛侵入性 CXPA (WICXPA) 经常导致与疾病相关的死亡。本研究的目的是分析腮腺 ICCXPA 或 MICXPA 与 WICXPA 之间临床病理特征的差异以及 WICXPA 的预后因素。 材料和方法：我们进行了一项回顾性队列研究。我们对 2001 年至 2012 年队列中原发性腮腺 CXPA 患者的临床病理参数进行了回顾。预测变量是一组异质因素，分为人口统计学、临床和病理特征。主要结果变量是肿瘤诊断，分为 3 类：ICCXPA、MICXPA 和 WICXPA。为了进行统计分析，将 ICCXPA 和 MICXPA 合并为 1 组，将 WICXPA 单独分析。使用 c2 检验或 t 检验评估 2 组（ICCXPA 加 MICXPA 与 WICXPA）之间临床病理参数的差异。次要结果变量是 WICXPA 患者的疾病特异性生存率 (DSS)。采用Kaplan-Meier法和Cox回归对WICXPA的生存数据进行统计分析。结果：共确诊CXPA 241例，其中ICCXPA 63例，MICXPA 52例，WICXPA 126例。 WICXPA 患者比 ICCXPA/MICXPA 患者年龄更大（59.6 岁 vs 51.4 岁；P < .001），并且肿瘤直径更大（3.9 vs 3.3 cm；P = .040）。 WICXPA 患者中组织学高级别肿瘤的比例 (P < .001)、癌比例超过 50% (P < .001) 和淋巴结受累的比例 (P < .001) 较高。 Cox回归分析表明，年龄、T分期和N分期是WICXPA患者DSS的独立预后因素。结论：年龄较大、T分期较晚、癌比例较高、组织学高级别发现和淋巴结受累与腮腺WICXPA相关。年龄、T分期、N分期是预测腮腺WICXPA患者预后的重要独立因素。 (C) 2020年美国口腔颌面外科医师协会
Purpose: Salivary intracapsular carcinoma ex pleomorphic adenoma (ICCXPA) and minimally invasive CXPA (MICXPA) generally have favorable outcomes. In contrast, widely invasive CXPA (WICXPA) frequently results in disease-related death. The aims of the present study were to analyze the differences in the clinicopathologic features between parotid gland ICCXPA or MICXPA and WICXPA and the prognostic factors for WICXPA.Materials and Methods: We performed a retrospective cohort study. The clinicopathologic parameters of patients with primary CXPA of the parotid gland from our 2001 to 2012 cohort were reviewed. The predictor variable was a set of heterogeneous factors grouped into demographic, clinical, and pathologic features. The primary outcome variable was the tumor diagnosis, grouped into 3 categories: ICCXPA, MICXPA, and WICXPA. For statistical analysis, ICCXPA and MICXPA were combined into 1 group, with WICXPA analyzed separately. The differences in the clinicopathologic parameters between the 2 groups (ICCXPA plus MICXPA vs WICXPA) were evaluated using the c2 test or t test. The secondary outcome variable was disease-specific survival (DSS) of those with WICXPA. The survival data for WICXPA were statistically analyzed using the Kaplan-Meier method and Cox regression.Results: A total of 241 cases of CXPA had been diagnosed, including 63 cases of ICCXPA, 52 cases of MICXPA, and 126 cases of WICXPA. The patients with WICXPA were older than were those with ICCXPA/MICXPA (59.6 vs 51.4 years; P < .001) and had a larger tumor diameter (3.9 vs 3.3 cm; P = .040). The proportion of histologic high-grade tumor (P < .001), proportion of carcinoma more than 50% (P < .001), and proportion of lymph node involvement (P < .001) was greater in those with WICXPA. Cox regression analysis indicated that age, T stage, and N stage were independent prognostic factors of DSS for those with WICXPA.Conclusions: Older age, later T stage, a greater proportion of carcinoma, histologic high-grade findings, and lymph node involvement were associated with parotid gland WICXPA. Age, T stage, and N stage were the important independent factors for predicting the prognosis of patients with parotid gland WICXPA. (C) 2020 American Association of Oral and Maxillofacial Surgeons