Clinical Analysis Of 150 Cases Of Salivary Gland Malignancies

ObjectiveSalivary gland malignancy is one of the relatively rare malignancies in head and neck carcinoma,with a wide range of histological subtypes and clinical manifestations.The clinical data of 150 cases of salivary gland malignancies patients admitted from March 2013 to October 2019 in Department of The Second Hospital of Dalian Medical University Oral and Maxillofacial Surgery were retrospectively analyzed.To study and discuss the epidemiology,clinical characteristics and related factors affecting the survival rate of patients with salivary gland malignancies.To clarify the diagnosis and treatment of salivary gland malignancies,it is helpful to improve the survival rate of patients and provide clinical data for the diagnosis and treatment of salivary gland malignancies.MethodsAll the clinical data of 150 cases with Salivary gland malignancies were collected from March 2013 to October 2019 in the Department of Oral and Maxillofacial Surgery in The Second Hospital of Dalian Medical University.The gender,regional position,age,pathological type,clinical symptoms,auxiliary examination,TNM stage,clinical stage,pathological grade,treatment method and prognosis of all 150 cases were analyzed by scientific statistics.Kaplan-Meier was used to estimate the survival rate of patients with salivary gland malignancies,SPSS software was application of the survival curve Logarithmic rank and COX regression model were used to analysis the prognostic factors with overall survival of salivary gland malignancies.Results1.In this study,there were a total of 150 patients with malignant salivary gland tumors,including 78 males and 72 females,from 17 to 94 years of age,the median age was 55 years,the mean age was 56 years,and it strikes most often at the ages from 60 to 69 years.The sex ratio of male to female in submandibular gland malignant tumor was 1.44,and that of male to female in palatal gland malignant tumor was 0.662.Salivary gland malignancies were occurred in 82 cases of parotid gland,22 cases of submandibular gland,8 cases of Sublingual gland,38 cases of small salivary gland,15 cases of palate.3.The most common pathological types were mucoepidermoid carcinoma(36 cases),adenoid cystic carcinoma(25 cases)and acinic cell carcinoma(19 cases).Other types of salivary gland malignancies mainly included cystadenocarcinoma,carcinoma in pleomorphic adenoma,salivary duct carcinoma,squamous cell carcinoma,epithelial-myoepithelial carcinoma,and malignant myoepithelial carcinoma.4.Salivary gland malignancies were accompanied by pain and neurological symptoms The rate of rapid intraoperative frozen diagnosis coincidence was 86.9%,the accuracy rate of fine needle aspiration cytology coincidence was 88.2%5.There were 90 cases of T1-T2,60 cases of T3-T4;25 cases of cervical lymph node metastasis and 125 cases without cervical lymph node metastasis;80 cases of clinical stageⅠ and Ⅱ,70 cases of Ⅲ and Ⅳ;59 cases of highly malignant tumors,35 cases of moderate malignant tumors,and 56 cases of low-grade malignant tumors;A total of 100 cases were treated with surgery alone,and 50 cases were treated with surgery combined with radiotherapy and chemotherapy.6.The median follow-up period of salivary gland malignancies was 38 months(range 4 to 79 months).The Kaplan-Meier calculated survival rate,3-year survival rate and 5-year survival rate were 78.2%and 71.7%respectively for patients with salivary gland malignancies.Log-rank test showed that T stage,clinical stage,cervical lymph node metastasis,pathological grade,treatment had statistical significance,while the gender,age and site statistic differences.COX regression model test showed that cervical lymph node metastasis,clinical stage,and pathological grade are independent prognostic factors that correlated with overall survival.The survival rate of clinical stage III and IV is lower than that of clinical stage I and II.The survival rate of patients with high pathologiacal grade is significantly lower than that of patients with low pathologiacal grade,and the survival rate of patients with surgery combined with radiotherapy is higher than that of patients with simple surgery.Conclusions1.Salivary gland malignancies can occur at any age,the most common in the parotid gland,followed by mandibular gland.In the small salivary gland mainly occurs in the palate.The malignant tumors of the submandibular gland were more in males than in females,and the malignant tumors of the palatal gland were more in females.2.Mucoepidermoid carcinoma,adenoid cystic carcinoma and acinic cell carcinoma are the most common pathological types.3.Rapid intraoperative frozen diagnosis and fine needle aspiration cytology are helpful for the diagnosis of salivary gland malignancies.4.The 3-year survival rate and 5-year survival rate were 78.2%and 71.7%respectively for patients with salivary gland malignancies.5.Log-rank test showed that T stage,clinical stage,cervical lymph node metastasis,pathological grade,treatment had statistical significance,while gender,age and site statistic differences.6.COX regression model test showed that cervical lymph node metastasis,clinical stage,pathological grade were independent prognostic factors of salivary gland malignancies.7.Postoperative radiotherapy for salivary gland malignancies with late clinical stage and poor degree of tumor differentiation can improve the survival rate,and postoperative adjuvant radiotherapy is recommended.