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目的:探讨口腔颌面-头颈部癌肉瘤(carcinosarcoma)的临床特征、病理特征、治疗方法及预后。方法:对上海交通大学医学院附属第九人民医院收集的10例口腔颌面-头颈部癌肉瘤患者的临床及病理资料进行分析,包括临床表现、影像学表现、病理表现、治疗及愈后等方面。结果:10例患者中,男8例,女2例;年龄20~81岁,平均44岁(中位年龄45.5岁)。肿瘤大小不一,直径在1.5 cm以上,与发生部位有关。临床表现多为异物感或迅速增大的肿物,甚至疼痛不适。病理证实含癌及肉瘤样间质,为癌肉瘤。临床上主要与鳞癌相鉴别,确诊取决于术后病理检查尤其是免疫组织化学分析。鳞状细胞癌为上皮样组织的恶性肿瘤,而癌肉瘤则兼有上皮样组织及间叶样组织。预后较差,5年生存率50%。结论:癌肉瘤确诊依赖于术后病理学检查,手术完整切除+血管化皮瓣修复+术后放疗为常规治疗方法,根据实际情况予以化疗。
Objective: To investigate the clinical features, pathological features, treatment and prognosis of oral and maxillofacial - head and neck carcinosarcoma. Methods: The clinical and pathological data of 10 patients with oral and maxillofacial-head and neck carcinosarcoma collected from the 9th People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were analyzed, including clinical manifestations, imaging findings, pathological findings, treatment and prognosis etc. Results: Of the 10 patients, 8 were males and 2 were females. The patients were 20 to 81 years old with a mean of 44 years (median 45.5 years). Tumor size varies from 1.5 cm in diameter to the site of occurrence. Clinical manifestations are mostly foreign body sensation or rapidly increasing mass, and even pain and discomfort. Pathology confirmed with cancer and sarcomatoid interstitial, for the carcinosarcoma. Mainly differentiated from squamous cell carcinoma clinical diagnosis depends on postoperative pathology, especially immunohistochemical analysis. Squamous cell carcinoma is a malignant tumor of epithelial-like tissue, while carcinoid sarcoma has both epithelial-like tissue and mesenchyme. Poor prognosis, 5-year survival rate of 50%. Conclusion: The diagnosis of carcinosarcoma depends on the postoperative pathological examination, complete resection + vascularized flap repair + postoperative radiotherapy for conventional treatment, according to the actual situation to be chemotherapy.