The Relationship Between The Grading Scheme Of Br Andwein And Prognosis Of Mucoepidermoid Carcinom A Of The Salivary Gland

Objective:Analyze the relationship between some clinical factors and pathological markers of the grading scheme of Brandwein and postoperative recurrence and metastasis for mucoepidermoid carcinoma (MEC) of the salivary gland.Study the relationship between each grade in different grading scheme and postoperative recurrence and metastasis for MEC of the salivary gland.Methods:Tumor recurrence and metastasis rate was estimated by life table method. In univariate analysis of the factors examined, the variables were tested by Kaplan-Meier method. In multivariate analysis, the COX proportional hazard model was used to screen the risk factors for recurrence and metastasis. Kaplan-Meier method was used to compare the 3years,5years, 10years recurrence and metastasis rate for each grade in different grading scheme for MEC of the salivary gland.Results:The estimated tumor recurrence and metastasis rates were (8.05%, 7.05%) at 3 years, (13.07%,12.07%) at 5 years, and (56.17%,34.20%) at 10 years, respectively. Univariate analysis showed that 10 factors were the influencing factors of the postoperative recurrence for MEC of the salivary gland, such as neural invasion, pathological grading B (using the scheme of Brandwein) and so on; 11 factors were the influencing factors of the postoperative metastasis for MEC of the salivary gland, such as necrosis, clinical stage and so on. Multivariate analysis showed that pathological grading B (F=0.027, OR>1), was the main influencing factor of the postoperative recurrence for MEC of the salivary gland. Necrosis (P=0.004, OR>1), was the main influencing factor of the postoperative metastasis for MEC of the salivary gland. 10years recurrence rate was 25.5%for low grade in pathological grading A (using the scheme of AFIP); There was no single patient with postoperative recurrence for low grade in pathological grading B. 5years, 10years metastasis rate were (50.35%,100%) respectively for intermediate grade in pathological grading A; There was no single patient with postoperative metastasis for intermediate grade in pathological grading B. Conclusion:As the risk of recurrence and metastasis appears to increase with time, for the patients with MEC of the salivary gland, a long-term follow-up for the patient may be appropriate. Pathological grading B was independent influencing factor of the postoperative recurrence for MEC of the salivary gland; Necrosis was independent influencing factor of the postoperative metastasis for MEC of the salivary gland. Compared with pathological grading A, pathological grading B may be the most objective grading scheme.