minor salivary gland carcinoma

小涎腺癌
  • 文章类型: Journal Article
    小唾液腺的癌是罕见的,具有异质性的病理。这项研究探索了人口统计学,组织学,瑞典人口的治疗和生存超过11年。
    口腔癌病例摘自“瑞典头颈部癌症登记处”(2008-2018年)。交叉制表的统计分析,年龄分组,卡方,进行了Kaplan-Meier方法和对数秩检验.
    纳入了330例病例(62%为女性;平均年龄60岁;83%为WHO表现状态0)。癌主要是I期(57%),最常见的部位是腭有165例肿瘤(50%)。最常见的组织学是粘液表皮样癌(30%),其次是多形性低级别腺癌(25%)和腺样囊性癌(24%)。各年龄组的组织学分布不同。5年预测总生存率为83%。大多数患者(89%)接受了初次手术治疗。
    人口统计,组织学,在瑞典人群中,口腔癌的生存率与先前发表的材料非常吻合。人口统计学和组织学与同一人群中主要唾液腺的癌不同。
    UNASSIGNED: Carcinomas of the minor salivary glands are rare with a heterogeneous pathology. This study explored the demographics, histology, treatment and survival in the Swedish population over 11 years.
    UNASSIGNED: Cases of salivary gland carcinomas in the oral cavity were extracted from the \'Swedish Head and Neck Cancer Register\' (2008-2018). Statistical analyses with cross tabulation, age grouping, chi-square, the Kaplan-Meier method and log-rank tests were performed.
    UNASSIGNED: Three hundred thirty cases were included (62% female; mean age 60 years; 83% were WHO Performance Status 0). The carcinomas were mostly stage I (57%), and the most common site was the palate with 165 tumours (50%). The most common histology was mucoepidermoid carcinoma (30%), followed by polymorphous low-grade adenocarcinoma (25%) and adenoid cystic carcinoma (24%). The distribution of histology differed between age groups. The five-year predicted overall survival rate was 83%. Most patients (89%) were treated with primary surgery.
    UNASSIGNED: The demographics, histology, and survival of minor salivary gland carcinomas in the oral cavity in the Swedish population correspond well with previously published material. The demographics and histology differ from carcinomas of the major salivary glands in the same population.
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  • 文章类型: Review
    目的:妊娠咯血是一个非常罕见的发现,导致诊断和治疗困难。介绍并讨论了一名29岁患者在怀孕31周时咯血的病例报告,以及提供的诊断过程和治疗方法。怀孕患者发生咽癌后,多学科医疗团队在足月分娩健康新生儿的同时进行了适当的治疗。在这份新创建的文献综述中,对患者和胎儿状况及结局进行了分析,并与现有文献进行了比较。
    方法:在使用公式“咯血”和“怀孕”进行MEDLINE数据库分析后,发现在2002-2022年期间发表了超过125个结果。发现了近30篇关于咯血的论文,并将其包括在内进行全面分析。
    结论:文献综述提供了以前报道的妊娠咯血事件的详细描述,以了解病因。鉴别诊断,患者和胎儿的可用治疗方法和预测的未来结局。
    OBJECTIVE: Hemoptysis in pregnancy is a very rare finding causing diagnostic and therapeutic difficulties. The case report of hemoptysis by a 29 years old patient in the 31st week of pregnancy is presented and discussed along with the diagnostic process and treatment provided.Upon pharyngeal cancer occurrence in a pregnant patient a multidisciplinary medical team performed appropriate treatment along with delivery of a healthy newborn at term. Patients and fetal conditions and outcomes were analyzed and compared to available literature in this newly created literature review.
    METHODS: After MEDLINE database analysis using formula \"hemoptysis\" AND \"pregnancy\" more than 125 results were found published during the period 2002-2022. Almost 30 papers about hemoptysis were found and included for full analysis.
    CONCLUSIONS: The literature review offers a detailed description of previously reported incidents of hemoptysis in pregnancy to gain understanding of the etiology, differential diagnosis, available treatment and predicted future outcomes for both patient and fetus.
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  • 文章类型: Case Reports
    粘液表皮样癌(MEC)是罕见的头颈部恶性肿瘤,最初被认为是良性的。据估计,主要唾液腺中约有20%的MEC,比如腮腺,在口腔中发现的几个小唾液腺中有50%,是恶性的。MECs的诊断主要基于辅助和免疫组织化学检测。然而,由于难以收集足够的材料进行组织学检查,口内MEC的组织病理学诊断可能特别具有挑战性.我们在此报告了一例罕见的82岁患者,该患者就诊于琉球大学医院口腔颌面外科,主诉舌尖腹面进行性肿胀和疼痛。该患者先前曾接受过穿刺活检,肿瘤的组织病理学分析提示诊断为刺激性纤维瘤。为了确保更准确的组织病理学评估,进行了切开活检,除了血液学和放射学评估。对获得的手术标本的检查证实了舌前腺的低度MEC。肿瘤是手术切除的,患者愈合顺利,在3年的常规随访中没有发现复发.尽管MEC在口腔的小唾液腺中相对更常见,它们在舌前腺中很少见。因此,应通过手术收集足够的组织学材料,以对肿瘤的形态和细胞学进行全面评估,并确保诊断的准确性。
    Mucoepidermoid carcinomas (MECs) are rare head and neck malignant tumours that were originally considered to be benign. It has been estimated that ~20% of MECs in the major salivary glands, such as the parotid gland, and 50% in the several minor salivary glands found in the oral cavity, are malignant. The diagnosis of MECs is mainly based on ancillary and immunohistochemistry testing. However, owing to the difficulty in harvesting adequate material for histological examination, the histopathological diagnosis of intraoral MECs may be particularly challenging. We herein report a rare case of an 82-year-old patient who presented to the Department of Oral and Maxillofacial Surgery of Ryukyu University Hospital with complaints of a progressive swelling and pain in the ventral surface of the apex of the tongue. The patient had previously undergone needle biopsy and the histopathological analysis of the tumour suggested a diagnosis of irritation fibroma. To ensure a more accurate histopathological assessment, an incisional biopsy was performed, in addition to the haematological and radiological assessments. Examination of the obtained surgical specimen confirmed low-grade MEC of the anterior lingual gland. The tumour was surgically excised, the patient healed uneventfully and no recurrence was detected on the regular 3-year follow-up. Although MECs are relatively more common in the minor salivary glands of the oral cavity, they are a rare occurrence in the anterior lingual gland. Therefore, adequate histological material should be surgically harvested to perform a complete evaluation of the morphology and cytology of the tumour and ensure the accuracy of diagnosis.
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  • 文章类型: Journal Article
    背景:我们研究了淋巴结的病理连续变量是否与头颈部小唾液腺癌的生存结果相关。
    方法:回顾性研究了44例小唾液腺癌同时进行了原发切除和颈清扫术的患者。通过阳性淋巴结的数量评估病理连续变量,淋巴结比率,并记录淋巴结阳性的几率。受试者工作曲线分析用于癌特异性死亡的截止值。使用Log-rank检验和Cox's比例风险模型进行单/多变量生存分析,调整病理分期,分别。
    结果:淋巴结比率=0.05以及阳性淋巴结的对数几率=-2.73预测了癌症特异性死亡。通过单因素分析,淋巴结比率和阳性淋巴结的对数几率与生存结果显着相关。淋巴结比率≥0.05与较短的疾病特异性相关(风险比=7.90,95%置信区间=1.54-57.1)。多变量分析中的无病生存(风险比=4.15,95%置信区间=1.48-11.2)和总体生存(风险比=4.84,95%置信区间=1.05-24.8).
    结论:小唾液腺癌的较高淋巴结比率是较短生存结果的预测因子。
    BACKGROUND: We investigate whether pathological continuous variables of lymph nodes were related with survival results of carcinomas of minor salivary gland carcinoma in head and neck.
    METHODS: Forty-four cases with minor salivary gland carcinoma who underwent both primary resection and neck dissection were retrospectively enrolled. The pathological continuous variables were evaluated by the number of positive lymph nodes, lymph node ratio, and log odds of positive lymph nodes. Receiver operating curve analysis was used for the cut-off values of the carcinoma-specific death. Log-rank test and Cox\'s proportional hazards model were used for uni-/multi-variate survival analyses adjusting for pathological stage, respectively.
    RESULTS: Lymph node ratio = 0.05 as well as log odds of positive lymph nodes = - 2.73 predicted the carcinoma-specific death. Both lymph node ratio and log odds of positive lymph nodes were significantly related with survival outcomes by the univariate analysis. Lymph node ratio ≥ 0.05 was associated with shorter disease-specific (hazard ratio = 7.90, 95% confidence interval = 1.54-57.1), disease-free (hazard ratio = 4.15, 95% confidence interval = 1.48-11.2) and overall (hazard ratio = 4.84, 95% confidence interval = 1.05-24.8) survival in the multivariate analysis.
    CONCLUSIONS: A higher lymph node ratio of minor salivary gland carcinoma is a predictor of shorter survival results.
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  • 文章类型: Journal Article
    Minor salivary gland carcinoma (MiSGC) is rare, and the understanding of this disease is insufficient. This study aimed to identify independent risk factors and develop a nomogram for evaluating the overall survival (OS) and cancer-specific survival (CSS) of patients with MiSGC.
    Retrospective cohort study.
    SEER database (Surveillance, Epidemiology, and End Results).
    We collected data from patients diagnosed with MiSGC between 2004 and 2015 from the SEER database. According to patient registration, all patients were randomly allocated to training sets and validation sets (2:1). Then, Kaplan-Meier product limit curves and Cox proportional hazard regressions were performed to estimate the prognostic effect of variables. Nomograms based on Cox proportional hazard regressions were established to estimate 3- and 5-year OS and CSS. Finally, the nomogram was developed by the training set, and validation was performed with the concordance index, calibration curves, and decision curve analyses.
    In total, 1787 MiSGC cases were registered in SEER. The concordance index for internal validation of OS and CSS prediction was 0.842 and 0.816; that of external validation was 0.871 and 0.831. The calibration plots showed good consistency between nomogram prediction and actual survival. The decision curve analysis showed substantial net benefits of the new predictive model.
    We constructed nomograms and a corresponding risk classification system predicting the OS and CSS of patients with MiSGC. These tools can generate simple-to-use clinical risk grouping and determine the relationship between adjuvant therapy and active surveillance.
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  • 文章类型: Journal Article
    目的:本研究的目的是开发和验证一种结合[18F]FDGPET/CT影像组学的小唾液腺癌(MSGC)患者的预后模型。
    方法:我们回顾性回顾了75例接受治疗的MSGC患者的治疗前[18F]FDGPET/CT图像。使用1.5:1的比例,患者被随机分为训练和验证组.主要结局指标为总生存期(OS)和无复发生存期(RFS)。所有患者均随访至少30个月或直至死亡。在PET图像上分割肿瘤和淋巴结后,提取放射学特征。使用受试者工作特征曲线分析检查了训练组中PET影像组学和临床参数的预后意义。将对OS和RFS有显著影响的变量输入多变量Cox回归模型。随后实施了递归分区分析,以设计预后指标,其性能在验证组中进行了检查。最后,将该指数的表现与整个队列中的临床变量以及手术治疗病例的列线图进行了比较.
    结果:训练和验证组包括45和30名患者,分别。整个队列的中位随访时间为59.5个月。18次复发,19死了,13次复发,在训练和验证队列中发现了8个死亡事件,分别。在训练组中,两个因素被确定为与操作系统差独立相关,即,(1)具有高最大标准化摄取值(SUVmax)和离散强度熵的肿瘤,以及(2)不良表现状态或N2c-N3阶段。设计了基于上述因素的预后模型,显示OS的一致性指数(C指数)明显高于AJCC分期和高危组织学(C指数:0.83vs.0.65,P=0.005;0.83vs.0.54,P<0.001)。该指数也显示出比OS列线图更好的性能(C指数:0.88vs.0.70,P=0.017)和RFS(C指数:0.87vs.0.72,P=0.004)。
    结论:我们设计了一种新的预后模型,该模型结合了[18F]FDGPET/CT影像组学,可能有助于改善MSGC患者的预后预测。
    OBJECTIVE: The aim of this study was to develop and validate a prognostic model incorporating [18F]FDG PET/CT radiomics for patients of minor salivary gland carcinoma (MSGC).
    METHODS: We retrospectively reviewed the pretreatment [18F]FDG PET/CT images of 75 MSGC patients treated with curative intent. Using a 1.5:1 ratio, the patients were randomly divided into a training and validation group. The main outcome measurements were overall survival (OS) and relapse-free survival (RFS). All of the patients were followed up for at least 30 months or until death. Following segmentation of tumors and lymph nodes on PET images, radiomic features were extracted. The prognostic significance of PET radiomics and clinical parameters in the training group was examined using receiver operating characteristic curve analysis. Variables showing a significant impact on OS and RFS were entered into multivariable Cox regression models. Recursive partitioning analysis was subsequently implemented to devise a prognostic index, whose performance was examined in the validation group. Finally, the performance of the index was compared with clinical variables in the entire cohort and nomograms for surgically treated cases.
    RESULTS: The training and validation groups consisted of 45 and 30 patients, respectively. The median follow-up time in the entire cohort was 59.5 months. Eighteen relapse, 19 dead, and thirteen relapse, eight dead events were found in the training and validation cohorts, respectively. In the training group, two factors were identified as independently associated with poor OS, i.e., (1) tumors with both high maximum standardized uptake value (SUVmax) and discretized intensity entropy and (2) poor performance status or N2c-N3 stage. A prognostic model based on the above factors was devised and showed significant higher concordance index (C-index) for OS than those of AJCC stage and high-risk histology (C-index: 0.83 vs. 0.65, P = 0.005; 0.83 vs. 0.54, P < 0.001, respectively). This index also demonstrated superior performance than nomogram for OS (C-index: 0.88 vs. 0.70, P = 0.017) and that for RFS (C-index: 0.87 vs. 0.72, P = 0.004).
    CONCLUSIONS: We devised a novel prognostic model that incorporates [18F]FDG PET/CT radiomics and may help refine outcome prediction in patients with MSGC.
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  • 文章类型: Journal Article
    BACKGROUND: Minor salivary gland carcinomas of the head and neck are rare cancers with variable clinical behavior. This study explored the incidence, pathology, clinical behavior, and factors predictive of outcomes in a large cohort of patients treated at Memorial Sloan Kettering Cancer Center over a 30-year period (1985-2015).
    METHODS: Clinical, pathological, treatment, and outcome data were collected. Unadjusted and adjusted hazard ratios for each variable were calculated with univariate and multivariable Cox regression for survival and recurrence outcomes.
    RESULTS: Four hundred fifty patients were included: 55% were female, 56% were younger than 60 years, and the median follow-up was 74 months (range, 1-364 months). The most common site was the oral cavity with 305 tumors (68%), which was followed by the oropharynx with 96 (21%), the sinonasal cavity with 38 (8%), the trachea with 7 (2%), and the larynx with 4 (1%). The most common histological types were mucoepidermoid carcinoma (180 tumors [40%]), adenoid cystic carcinoma (141 tumors [31%]), and polymorphous low-grade adenocarcinoma (54 tumors [12%]). The 5-year predicted overall survival rate was 86%, and the disease-specific survival rate was 94% at 5 years. Pathology and tumor stage were significant variables on multivariate analysis for overall survival, disease-specific survival, recurrence-free survival, local recurrence-free survival, regional recurrence-free survival, and distant recurrence-free survival.
    CONCLUSIONS: American Joint Committee on Cancer stage and pathology were the most predictive variables across all outcomes. Tumor site, postoperative radiotherapy, and margin status were not statistically significant variables after tumor stage and pathology were controlled for in most outcomes.
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  • 文章类型: Journal Article
    目的:原发性肿瘤手术(PTS)在诊断时伴远处转移(DM)的小唾液腺癌(MiSGC)中的预后价值从未被研究过。在这项研究中,我们旨在提供第一个证据。
    方法:监测,流行病学,和最终结果(SEER)数据库用于识别诊断时患有DM的MiSGC患者。通过Kaplan-Meier方法评估PTS的预后价值,对数秩分析,和多变量Cox比例风险回归模型。
    结果:在我们研究的152名符合条件的患者中,50人(32.9%)接受了PTS。Kaplan-Meier分析显示,与没有PTS的同行相比,PTS组的1年和2年总生存率(OS)和癌症特异性生存率(CSS)增加了>20%(PTS组vs无PTS组,1年操作系统66.1%对43.9%,1年CSS69.9%对44.9%,两年操作系统56.6%对24.2%,2年CSS59.9%对25.7%)。与非PTS组相比,多变量分析还显示PTS组的总死亡率(HR0.601,95%CI0.379-0.952;P=0.031)和癌症特异性死亡率(HR0.547,95%CI0.336-0.891;P=0.015)的风险显著降低。亚组多变量分析显示T1-T3口咽患者,鼻腔,或鼻旁窦原发性MiSGC,尤其是腺样囊性癌,可能受益于PTS(均P<0.05)。
    结论:PTS与高度选择的MiSGC患者的生存率提高相关,可在未来的临床实践中加以考虑。然而,仍有必要进行更大样本量的前瞻性研究来验证我们的研究结果.
    OBJECTIVE: The prognostic value of primary tumor surgery (PTS) in minor salivary-gland carcinoma (MiSGC) with distant metastasis (DM) at diagnosis has never been investigated. In this study, we aimed to provide the first evidence.
    METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was employed to identify MiSGC patients with DM at diagnosis. The prognostic value of PTS was evaluated by Kaplan-Meier methods, log-rank analyses, and multivariate Cox proportional-hazard regression models.
    RESULTS: Of the 152 eligible patients included in our study, 50 (32.9%) had undergone PTS. Kaplan-Meier analyses showed that the PTS group had >20% increase in 1- and 2-year overall survival (OS) and cancer-specific survival (CSS) compared with their counterparts without PTS (PTS group vs no-PTS group, 1-year OS 66.1% vs 43.9%, 1-year CSS 69.9% vs 44.9%, 2-year OS 56.6% vs 24.2%, 2-year CSS 59.9% vs 25.7%). Compared with the no-PTS group, multivariate analyses also demonstrated a significantly decreased risk of overall mortality (HR 0.601, 95% CI 0.379-0.952; P=0.031) and cancer-specific mortality (HR 0.547, 95% CI 0.336-0.891; P=0.015) in the PTS group. Subgroup multivariate analyses revealed patients with T1-T3 oropharynx, nasal cavity, or paranasal sinus primary MiSGC, especially adenoid cystic carcinoma, might benefit from PTS (all P<0.05).
    CONCLUSIONS: PTS is associated with improved survival in highly selected MiSGC patients and may be considered in future clinical practice. However, prospective studies with larger sample size are still necessary to validate our findings.
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  • 文章类型: Journal Article
    目的我们试图描述病人,肿瘤,和小涎腺癌(MSGC)的口咽的生存特征,基于人口的数据库。研究设计国家癌症研究所SEER数据库的横断面分析(监测,流行病学。和最终结果)。受试者和方法我们回顾了1988年至2013年所有口咽MSGC病例的SEER数据库。相关人口统计,临床病理,和生存变量进行提取和分析。采用Cox多因素回归分析确定预后因素。结果我们确定了1426例口咽MSGC(平均年龄,58岁;51%为女性)。最常见的受累部位为软腭(39.2%)和舌根(38.6%)。最常见的组织学亚型是粘液表皮样癌(32.1%),腺癌(25.9%),腺样囊性癌(23.3%)。5年和10年的疾病特异性生存率分别为75.1%和61.6%。分别。独立的预后因素包括肿瘤分级,T级,N级,年龄>70岁。结论本研究代表了迄今为止最大的口咽部MSGC的多变量生存分析。独立的预后指标包括肿瘤分级,T级,N级,和年龄。
    Objective We sought to describe the patient, tumor, and survival characteristics of minor salivary gland carcinoma (MSGC) of the oropharynx using a large, population-based database. Study Design Cross-sectional analysis of the National Cancer Institute\'s SEER database (Surveillance, Epidemiology. and End Results). Subjects and Methods We reviewed the SEER database for all cases of MSGC of the oropharynx from 1988 to 2013. Relevant demographic, clinicopathologic, and survival variables were extracted and analyzed. Cox multivariate regression was performed to identify prognostic factors. Results We identified 1426 cases of MSGC of the oropharynx (mean age, 58 years; 51% female). The soft palate (39.2%) and base of tongue (38.6%) were the most commonly involved sites. The most common histologic subtypes were mucoepidermoid carcinoma (32.1%), adenocarcinoma (25.9%), and adenoid cystic carcinoma (23.3%). Five- and 10-year rates of disease-specific survival were 75.1% and 61.6%, respectively. Independent prognostic factors included tumor grade, T stage, N stage, and age >70 years. Conclusions This study represents the largest multivariate survival analysis of MSGC of the oropharynx to date. Independent prognosticators include tumor grade, T stage, N stage, and age.
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