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Abstract：
The aim of the present study was to analyze the clinical characteristics, surgical treatments and clinical outcome of patients with parotid gland tumors and to compare the results with those cited in the literature. A retrospective study was conducted in 140 patients (male, n=77; female, n=63) with parotid gland tumors who underwent parotidectomy at Hokuto Hospital Department of Otolaryngology-Head and Neck Surgery (Obihiro, Japan) between April 2007 and December 2021. Of the 140 patients enrolled, 118 (84.3%) patients had benign tumors, including 63 (45%) patients with pleomorphic adenomas and 43 (30.7%) patients with Warthin tumors, and 22 patients (15.7%) had parotid carcinoma. Comparison of the three groups of patients with parotid gland tumors indicated that pack years as an indicator of smoking status were significantly higher in patients with Warthin tumors than in those with parotid carcinomas (P=0.011) or pleomorphic adenoma (P<0.001). Fine-needle aspiration cytology (FNAC) was non-diagnostic for only 6 (4.3%) of 140 patients. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC by both conventional smear and liquid-based cytology (LBC) for parotid carcinomas were 70, 99, 93.3, 94.4 and 82.9%, respectively. Among the 22 patients with parotid carcinoma, extended total/total and superficial parotidectomy were performed in 10 (45%) and 11 (50%) cases, respectively. Total and selective neck dissection of the area from level II to I, II and III were performed in 6 (24%) and 7 (32%) patients, respectively. Postoperative radiotherapy (50 Gy) was performed in 15 (68%) patients. The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 51.5 and 76.4%, respectively. Univariate analysis revealed that age >65 years was significantly associated with poorer 5-year OS (P<0.001) and DFS (P<0.001). Multivariate analysis revealed that an age of more than 65 years combined with high-grade histologic malignancy was associated with worse DFS (P=0.02; hazard ratio, 3.628; 95% confidence interval, 1.283-9.514). In conclusion, the clinical characteristics and treatment outcomes of parotid gland tumors were consistent with the results of previous reports. Smoking may be closely related to the pathogenesis of Warthin tumors. LBC potentially provides improved accuracy in FNAC.
摘要：
本研究的目的是分析临床特点，腮腺肿瘤患者的手术治疗和临床结果，并将结果与文献中引用的结果进行比较。对140例患者进行了回顾性研究（男性，n=77；女性，n=63）在Hokuto医院耳鼻咽喉头颈外科（Obihiro，日本）在2007年4月至2021年12月之间。在140名患者中，118例（84.3%）患者有良性肿瘤，包括63例（45%）多形性腺瘤患者和43例（30.7%）Warthin肿瘤患者，腮腺癌22例（15.7%）。三组腮腺肿瘤患者的比较表明，Warthin肿瘤患者的吸烟年数明显高于腮腺癌（P=0.011）或多形性腺瘤（P<0.001）。细针抽吸细胞学（FNAC）仅对140例患者中的6例（4.3％）没有诊断性。敏感性,特异性，正预测值，通过常规涂片和液基细胞学（LBC）对腮腺癌的FNAC阴性预测值和准确性分别为70、99、93.3、94.4和82.9％，分别。在22例腮腺癌患者中，在10例（45%）和11例（50%）中进行了扩大的全/全和浅表腮腺切除术，分别。从II级到I级的区域的完全和选择性颈部解剖，II和III分别在6例（24％）和7例（32％）患者中进行，分别。术后放疗（50Gy）15例（68％）。5年总生存率(OS)和无病生存率(DFS)分别为51.5%和76.4%,分别。单因素分析显示年龄>65岁与5年OS(P<0.001)和DFS(P<0.001)显著相关。多变量分析显示，年龄超过65岁合并高级别组织学恶性肿瘤与不良DFS相关（P=0.02；风险比，3.628；95%置信区间，1.283-9.514)。总之,腮腺肿瘤的临床特征和治疗结果与以前报道的结果一致。吸烟可能与Warthin肿瘤的发病机制密切相关。LBC潜在地在FNAC中提供改进的准确度。
