A Clinical Study On 75 Cases Of Adenoid Cystic Carcinoma Of Salivary Glands

[Objective] Adenoid cystic carcinoma of salivary glands (ACCs)is a highly invasive epithelial tumor from the salivary glands. ACCs is the second position of the malignant salivary gland tumors and accounts 21. 9%-24% of them. It usually occurs in the parotid gland, submandibular gland, sublingual gland and small salivary glands in palate. ACCs has strong local invasion, high blood transfer rate, poor long-term prognosis and other typical features of tumor biology. Currently, ACCs is mostly implemented the comprehensive treatment giving priority to surgery. But for the prevention of local recurrence and distant metastasis after operation, there are short of effective prevention and therapeutical measures. This is the difficulty of the treatment of ACCs.The purpose of this study is to analyze the clinical featuresof ACCs, to summarize clinical experience and to evaluate curative effect and factors affecting local recurrence.[Material and methods] A retrospective review was conducted in 75 patients with ACCs treated in our hospital from June in 1986 to December in 2005. All patients were given surgical treatment, 28 of which additionally received postoperative radiotherapy. The patients with ACCs were followed up for 1～ 17 years. Chi-square test and Fisher's exact test of statistical software SPSS10.0 were employed to analysis the relative factors of affecting local recurrence.[Results] 53. 3% of 75 patients (40/75) clinically manifested nerve paralysis and pain, numbness, facial paralysis or movement disorder of tongue. The overall local recurrence rate was 41. 3% (31/75). The overall local control rates of 5-, 10～and 15-year were 80. 1%, 58. 7% and 42.6%. The results showed that treatment, surgical margins and clinical phases of the ACCs have significant impacts on the local recurrence. Pulmonary metastasis rate of ACCs was 21. 3% (16/75), regional lymph node metastasis rate of ACCs was 6. 7% (5/75).[Conclusion] Adenoid cystic carcinoma of salivary glands (ACCs)is a slow-growing tumor with clinical symptoms of pain or paresthesia. The treatment of ACCs takes a large-scalecomplete surgical resection on the basis of preservation function, conventional postoperative radiotherapy. It generally needs not prophylactic neck dissection, and folLow-up time is more than 15 years. Conventional chest X-ray check is taken to confirm whether there are pulmonary metastases.