李超, 徐义全, 樊晋川. 腮腺多形性腺瘤安全手术切缘研究进展[J]. 中国肿瘤临床, 2011, 38(4): 238-240 . DOI: 10.3969/j.issn.1000-8179.2011.04.017
引用本文: 李超, 徐义全, 樊晋川. 腮腺多形性腺瘤安全手术切缘研究进展[J]. 中国肿瘤临床, 2011, 38(4): 238-240 . DOI: 10.3969/j.issn.1000-8179.2011.04.017

腮腺多形性腺瘤安全手术切缘研究进展

  • 摘要: 腮腺多形性腺瘤是最常见的涎腺肿瘤,约占所有涎腺肿瘤的60%~70%。该肿瘤以组织病理形态学多样性为特点,主要由包膜、上皮细胞、黏液间质及软骨样组织等成分组成。其标准处理方法是外科手术切除,手术治疗的原则是彻底切除原发部位的病灶。单纯肿瘤剜除术的复发率高达10%~45%, 这种高复发率导致手术方式的改变, 随着人们对该病的进一步研究认识及对面神经解剖的熟悉, 许多学者研究发现包膜的组织病理学特征对多形性腺瘤的复发率有重要影响、 剜除术后包膜浸润、 伪足、卫星结节等残留导致术后复发。越来越多的学者开始接受腮腺浅叶切除术是腮腺浅叶多形性腺瘤的经典术式,术后的复发率在0.3%~4%。然而有少数学者主张常规行腮腺全切除术。理由是腮腺多形性腺瘤的多中心论。同时有学者研究发现腮腺囊外切除术和区域性切除术复发率与腮腺浅叶切除术相当,术后患者腮腺功能保留并且面貌改变小以及并发症发生率降低。在达到疗效的目的下降低并发症, 保留腮腺功能,提高患者生存质量,是医患双方的共同愿望。但该术式的具体切除范围仍不明确。本文对腮腺多形性腺瘤的外科安全手术切缘研究进展予以综述。

     

    Abstract: Advances in the Research of Surgical Margins for Pleomorphic Adenoma of Parotid GlandChao LI1, Yiquan XU2, Jinchuan FAN1Corresponding author: Jinchuan FAN, E-mail: xuyqqing@163.com1Department of Head and Neck Surgery, Sichuan Cancer Hospital & Cancer Institute, Chengdu 610041, China2Guangxi Medical University, Nanning 530021, ChinaAbstract Pleomorphic adenoma is the most common neoplasm of the salivary glands, accounting for about 60%~70% of all pa-rotid tumors. The benign mixed tumor is composed of epithelial and myoepithelial cells arranged in various morphological patterns andsubtypes. The standard treatment for pleomorphic adenoma is surgery. After the simple procedure of tumor enucleation, the recurrencerate varies from 10% to 45%. More and more studies showed that the occasional local recurrence of benign pleomorphic adenoma (PA)was correlated with the histopathology of the tumor capsule. After enucleation, residual focal infiltration of the tumor capsule, pseudo-podia or satellite of the pleomorphic adenoma can lead to recurrence. Therefore, it is generally accepted that the standard surgical proce-dure for pleomorphic adenoma of the superficial parotid gland is superficial parotidectomy. Some authors have proposed total superfi-cial parotidectomy due to theory of multicentricity of pleomorphic adenoma. These procedures can help decrease the recurrence rate to0.3% to 4%. Some other authors have proposed extracapsular dissection or partial superficial parotidectomy, which could save the func-tion of the parotid gland and does not raise the recurrence rate. Recent advances in the research of the safe surgical margins for pleomor-phic adenoma were reviewed in this article.Keywords Pleomorphic adenoma; Parotid gland; Safe surgical margin; Molecule margin

     

/

返回文章
返回