腮腺多原发性肿瘤54例临床分析

                                    作者：李纪奎 王玉栓 王玉良 杨佑成 徐杰

【摘要】  目的 了解腮腺多原发肿瘤临床特点、病理类型及生存现状。方法 分析腮腺多原发肿瘤病理类型、患者性别、年龄、生活习惯等。结果 所分析病例中腺淋巴瘤占56%(30例)，其次为混合瘤占20%(11例)。单侧35例，双侧19例，同时性肿瘤44例，异时性肿瘤10例，男女比例为2.6∶1，平均年龄58岁(23～80岁)，34例嗜好吸烟，70%采用了保留面神经的瘤体及腮腺浅叶切除术。结论 腮腺多原发性肿瘤大多数为腺淋巴瘤，其次为多形性腺瘤，男性好发，吸烟是该病重要致病因素，保留面神经的瘤体及腮腺浅叶切除术为最佳治疗方式。 
【关键词】  肿瘤；多原发肿瘤；腮腺；腺淋巴瘤
    【Abstract】  Objective  To study the clinical characteristics ,the type of pathology and life status of the multiple primary tumors in parotid gland.Methods  To analyze the multiple primary tumors in parotid gland about the type of pathology, sex, age, smoking and drinking history,etc.Results  Most of the multiple primary tumors in parotid gland are adenolymphoma accounted for 56 percent(30 case),the following are pleomorphic adenoma accounted for 20 percent(11 case), 35 patients were  unilateral parotid, 19 patients were bilateral parotid.The tumors were found and diagnosed synchronously in 44 patients, and metachronously in 10 patients; the male: female ratio of the multiple primary tumors is 2.6∶1. The median age was 58 years (range 23 to 80 years).34 patients were heavy smokers, 70% of all patients are taken lateral parotidectomy.Conclusion  Most of the multiple primary tumors in parotid gland are adenolymphoma, the following are pleomorphic adenoma.The multiple primary tumors were more common in men,smoking was a very important malgenic factor,and  lateral parotidectomy was an optimal treatment of these tumors.
    【Key words】  tumor, multiple primary tumors, parotid gland, adenolymphoma
    多原发性肿瘤（multiple primary tumors，MPTs）是指同一宿主的单个器官或多个器官同时或先后发生两个或者两个以上原发性肿瘤，根据确诊先后顺序可分为先证肿瘤(index cancer)即第一原发肿瘤和第二原发肿瘤。随着人们生活水平的提高,就医条件的改善及人平均寿命延长，临床诊断技术水平不断增加，腮腺多原发肿瘤的发生有逐年增加趋势。本文对我院口腔颌面外科近20年腮腺多原发肿瘤临床资料做一回顾性分析，现报告如下。
    1  资料与方法
    1.1  一般资料  1988—2008年我院收治腮腺肿瘤1102例，其中多原发肿瘤54例，占4.9%。其中男39例，女15例，男女比例2.6∶1，年龄23～80岁（平均58岁），以50～70岁居多，本组男性患者中31例为长期严重吸烟者,23例患者还有长期饮酒嗜好；女性患者中有3例为长期严重吸烟者,1例有饮酒嗜好。
    1.2  临床表现  MPTs多为无痛性生长，质韧，多结节状，无触、压痛，活动，个体带瘤生长时间为2周～25年。腮腺下极为最好发部位19/54例（35%），瘤体直径1～8 cm，双侧19例，单侧35例，且多为右侧，占65.7%（23/35）。

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