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目的观察唾液腺黏液表皮样癌(MEC)术后生存率及不同临床分期患者的生存率,并确定影响术后生存的主要临床病理因素。方法对119例MEC按照临床流行病学关于预后研究的方法进行数据收集,乘积-极限法计算术后各时点的观察生存率,时序检验各临床病理因素对术后观察生存率的影响。结果119例唾液MEC患者术后总体的5、10、15年生存率分别为:92·53%、87·52%、85·39%。年龄≥40岁、TNMⅢ、Ⅳ期、低分化患者术后生存率分别显著低于年龄<40岁、TNMⅠ、Ⅱ期、高分化患者(P<0·05),大唾液腺MEC男性患者术后生存率明显低于女性(P=0·008)。分化程度、TNM分期及术前症状是进入Cox比例风险回归模型的3个对术后生存率有显著影响的主要因素。结论高分化型唾液腺MEC属于预后相对较好的恶性肿瘤,分化程度、TNM分期是影响患者预后的重要临床病理因素。
Objective To observe the postoperative survival rate of salivary mucoepidermoid carcinoma (MEC) and the survival rate of patients with different clinical stages, and to determine the main clinical and pathological factors that influence postoperative survival. Methods 119 cases of MEC were collected according to the method of clinical epidemiology about prognosis. The product survival rate was calculated by product-limit method at each time point. The effect of each clinicopathological factors on the survival rate after operation was examined. Results The overall 5-year, 10-year and 15-year survival rates of 119 patients with salivary MEC were 92.53%, 87.52% and 85.39% respectively. The survival rates of TNMⅢ and Ⅳ, poorly differentiated patients were significantly lower than those of patients aged <40 years, TNMⅠand Ⅱ, well-differentiated patients (P0.05), and those with large salivary glands The rate was significantly lower than that of women (P = 0.008). Differentiation, TNM staging and preoperative symptoms were the three major factors that had a significant effect on postoperative survival rate in the Cox proportional hazards regression model. Conclusions MEC with well-differentiated salivary gland belongs to malignant tumor with relatively good prognosis. Differentiation degree and TNM stage are important clinical and pathological factors affecting the prognosis of patients.