Retrospective Analysis Of 38 Cases Of Salivary Gland Adenoid Cystic Carcinoma

Objective: In this paper,we retrospectively analyzed the clinical data of 38 cases of salivary gland adenoid cystic carcinoma,and discussed the clinical characteristics and prognostic factors of adenoid cystic carcinoma,so as to provide some experience for clinical treatment.Methods: 38 patients with adenoid cystic carcinoma of salivary gland in our hospital from January 2012 to June 2020 were reviewed,including 12 male patients and 26 female patients.The clinical features,imaging features,treatment methods and prognosis were analyzed and compared.All the selected patients in this article were confirmed by pathology.Results: Of the 38 patients,12 cases accounted for 31.6%(12/38),26 cases accounted for 68.4%(26/38),the male to female ratio was 6:13,showing more women,but there was no significant correlation with postoperative survival rate(p >0.05).The youngest age of onset was 26 years and the oldest was 90 years,the median age was 69 years old,but there was no significant correlation with postoperative survival rate(p >0.05).Among the lesion sites,the submandibular gland(36.8%)was found in 14 cases(14/38),the palatal gland(18.4%)in 7 cases(7/38),the parotid gland(31.6%)in 15 cases(12/38),the sublingual gland(5.3%)in 2 cases(2/38),the base of the tongue(2.6%)in 1 cases(2/36),and the labial gland(5.3%)in 2 cases(2/38).There was no correlation between the site of the lesion and the survival rate(p >0.05).CT showed soft tissue density in 24 cases,1 of whom invaded surrounding bone.MRI in 11 cases indicated that T1 WI and T2 WI presented isometric irregular signals.All the patients were examined by histopathology.The pathological types were in accordance with the histological classification of salivary gland tumors modified by WHO in 2005.There were 20 cases of sieve type,5 cases of solid type and 13 cases of tubular type.There was no correlation between the pathological type and the survival rate(p>0.05).According to the 2010 UICC Seventh Edition TNM classification of head and neck tumors,15 cases of stage I(39.5%,15/38),15 cases of stage II(39.5%,15/38),6 cases of stage III(15.8%,6/38),and2 cases of stage IV(5.2%,2/38)were staged.The survival rates of stage I and stage II were higher(p <0.05).27 patients were treated with surgery alone,2 patients were treated with surgery + radiotherapy + chemotherapy,and 9 patients were treated with surgery + radiotherapy.The patients were followed up to January 2021 for 8-105 months,with a median survival time of 83 months.There was no correlation between the treatment method and the survival rate(p >0.05).Among the 38 patients followed up,9patients had local recurrence after surgery,5 patients had distant metastasis,32 patients survived,4 patients died of local recurrence,and 2 patients died of distant metastasis.There was no significant correlation between the local recurrence and distant metastasis and the survival rate.Conclusion: According to the results of the study in the salivary gland adenoid cystic carcinoma in elderly group,women were more prone than men.Gender,lesion site,treatment method,pathological type,local recurrence and distant metastasis were not related to postoperative survival rate,while age and clinical stage were related to postoperative survival rate.Solid pathological type,postoperative recurrence,and distant metastasis are risk factors that affect the prognosis of patients,and can reduce their survival time after operation.Surgical operation plus radiotherapy/chemotherapy are protective factors for adenoid cystic carcinoma and can prolong the survival time of patients after operation.