| Objective:In this reserch,we aim to provide clinical data for the diagnosis of salivary gland tumors, especially for the diagnosis and treatment of pleomorphic adenoma,by investigating the constituent ratio and morbidity rate of salivary gland tumors in Changchun area,exploring the relevance between the clinical and pathological characteristics of pleomorphic adenoma and its malignant transformation. Materials and Methods:All the clinical data of 1345 cases of salivary gland tumors were from the patients vis ited to the Oral and maxillofac ial surgery department in Stomatological Hospital of Jilin Univers ity from January 2011 to January 2016.We collect,statistical process, and analyze the clinical and pathological data like the gender, age, position, pathologic al type and so on,simultaneously review the literature to investigate the constituent ratio and morbidity rate of salivary gland tumors and explore the associated clinical signs of the pleomorphic adenomas malignant transformation. Results:1.Benign salivary gland tumors account for about 79.85%,while the proportion of the malignancy is lower accounting for 20.15% 。The incidence of pleomorphic adenoma is highest in all the salivary gland tumors,accounting for about 47.96%.The most common site we can see the salivary gland tumors is the parotid gland,accounting for about 71.00% in all the salivary glands.Female patients with salivary gland tumors(53.53%) is more than male patients(46.47%).The male patients to female patients ratio is 0.87: 1.In this study,the age of onset of salivary gland tumors is in the range of 3 to 83 years, and the mean age is 49.42 years.2.In all the 681 pleomorphic adenoma cases,the benign ones(94.71%) is more than the malignant ones(5.29%).Benign and malignant ratio is about 17.92: 1.The male patients to female patients ratio is 0.55: 1. The age of onset range from 9 to 83 years and the mean age is 44.22 years.3.The malignant transformation rate in mail pleomorphic adenoma cases is 7.85%.The malignant transformation rate in femail pleomorphic adenoma cases is 3.87%.The malignant transformation rate in over 80 years old cases is highest(about 33.33%), followed by 71 to 80 years old team(21.74%), and 61 to 70 years old team(12.28%).The primary pleomorphic adenoma to the recurrent pleomorphic adenoma ratio is about 9.64: 1, The malignant transformation rate in primary pleomorphic adenoma is about 3.89%,while in recurrent pleomorphic adenoma accounts for 18.75%.4.The malignant transformation rate in the pleomorphic adenoma cases with accelerated tumor growth is 6.25%, while accounting for about 5.19% in the pleomorphic adenoma cases without accelerated tumor growth.The malignant transformation rate in the pleomorphic adenoma cases with facial nerve damage is 66.67%, while accounting for about 5.01% in the pleomorphic adenoma cases without facial nerve damage. The malignant transformation rate in the pleomorphic adenoma cases with a symptom of pain is 12.50%, while accounting for about 4.64% in the pleomorphic adenoma cases without a symptom of pain. In this study,there are 632 cases that the situation of the tumor capsule can be investigated, inc luding 600 benign cases and 32 malignant cases. The malignant transformation rate in the pleomorphic adenoma cases with complete tumor capsule(counted 559 cases) is 4.29%, while the incomplete tumor capsule cases(counted 73 cases)with a malignant transformation rate of 10.96%.5.In this study, a total of 161 cases diagnosed as malignant pleomorphic adenoma, recurrent pleomorphic adenoma or the pleomorphic adenoma that the tumor cells actively growing were followed up.There are 84 cases(52.17%)available,and 77 cases(47.83%)lost. The follow-up time is 3 months to 5 years after operation.There are 12 cases with no indication of recurrence(accounting for 80.00%),1 metastasis cases(accounting for 6.67%),and 2 deaths(accounting for 13.33%) in all the follow-up available 15 patients with malignant pleomorphic adenoma.There are 33 cases with no indication of recurrence(accounting for 84.62%),5 recurrent cases(accounting for 12.82%),and 1 death case(accounting for 2.56%) in all the follow-up available 39 patients with recurrent pleomorphic adenoma. This 1 Death case is a overlapping case with the above-mentioned malignant pleomorphic adenoma cases.There are 43 cases with no indication of recurrence(accounting for 95.56%),2 recurrent cases(accounting for 4.44%),in all the follow-up available 45 patients with the pleomorphic adenoma that the tumor cells actively growing. Conclusions:1.The benign ones accounts more in salivary gland tumors,and the most common tumor of the salivary gland is pleomorphic adenoma. The salivary gland tumors mostly occurred in ages of 51 to 60 years, followed by 41 to 50 years old,and it prefers the female, that may due to the clinical constituent ratio and morbidity rate of salivary gland tumors while some tumors’ morbidity rate gets an obvious gender differences. The salivary gland tumors occur in the parotid salivary gland mostly.The sublingual gland tumors are mostly malignant salivary gland tumors.In all the minor salivary glands,the salivary gland tumors occur mostly in the palate.2.Pleomorphic adenoma is "critical tumor" that the malignant transformation rate of is about 5.29%.The malignant transformation of pleomorphic adenoma is related to gender factors,age factors, and recurrence factors.These three factors get prompted significance for the diagnosis of the malignant transformation of pleomorphic adenoma.3.It’s helpful for the diagnosis of the malignant transformation of pleomorphic adenoma when the patients get a pain symptom,facial paralysis or the tumor capsule is incomplete.4.When the pleomorphic adenoma tumors got a pathological diagnosis of active cell growth relapse,it may get a high risk of malignant transformation. But as the sample capacity of malignant pleomorphic adenoma is small,there are some errors in statistical analyzing the malignant transformation of pleomorphic adenoma related factors.And it can still further increase the sample size to increase the accuracy.5.Literature reviewing shows the malignant transformation of pleomorphic adenoma is a multifactorial,multi-gene mutation process in view of the related genetic factors. |
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