87例唾液腺导管癌患者的治疗策略与预后分析：一项回顾性队列研究

张希梅; 周熠轩; 赵妍; 周旋; 王旭东; 严颖彬; 王佩国

doi:10.19401/j.cnki.1007-3639.2025.11.007

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87例唾液腺导管癌患者的治疗策略与预后分析：一项回顾性队列研究

论著 | 更新时间：2025-12-31

- 87例唾液腺导管癌患者的治疗策略与预后分析：一项回顾性队列研究
- Treatment strategies and prognostic analysis of 87 patients with salivary duct carcinoma: a retrospective cohort study
- 中国癌症杂志 2025年35卷第11期页码：1049-1055
- 作者机构：
  
  1. 天津医科大学肿瘤医院放疗科，国家恶性肿瘤临床医学研究中心，天津 300060
  2. 天津市恶性肿瘤临床医学研究中心，天津 300060
  3. 天津医科大学口腔临床学院，天津 300070
  4. 南开大学医学院附属天津市口腔医院口腔颌面头颈外科，天津 300041
  5. 天津市口腔颌面功能重建重点实验室，天津 300041
  6. 天津医科大学肿瘤医院颌面外科，国家恶性肿瘤临床医学研究中心，天津 300060
- 作者简介：
  
  [ "张希梅（ORCID: 0000-0001-9953-3066），博士，副主任医师。" ]
  [ "周熠轩（ORCID: 0009-0003-5686-1520），硕士。" ]
  严颖彬（ORCID: 0000-0001-9953-3066），博士，主任医师，E-mail: yingbinyan@qq.com；
  王佩国（ORCID: 0009-0002-9972-5038），博士，主任医师，E-mail: wpg2017@163.com。
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2025.11.007
  中图分类号： R739.87
- 收稿：2025-08-27，
  
  修回：2025-11-05，
  
  纸质出版：2025-11-30
- 稿件说明：
移动端阅览
张希梅, 周熠轩, 赵妍, 等. 87例唾液腺导管癌患者的治疗策略与预后分析：一项回顾性队列研究[J]. 中国癌症杂志, 2025,35(11):1049-1055.

Ximei ZHANG, Yixuan ZHOU, Yan ZHAO, et al. Treatment strategies and prognostic analysis of 87 patients with salivary duct carcinoma: a retrospective cohort study[J]. China Oncology, 2025, 35(11): 1049-1055.
张希梅, 周熠轩, 赵妍, 等. 87例唾液腺导管癌患者的治疗策略与预后分析：一项回顾性队列研究[J]. 中国癌症杂志, 2025,35(11):1049-1055. DOI： 10.19401/j.cnki.1007-3639.2025.11.007.

Ximei ZHANG, Yixuan ZHOU, Yan ZHAO, et al. Treatment strategies and prognostic analysis of 87 patients with salivary duct carcinoma: a retrospective cohort study[J]. China Oncology, 2025, 35(11): 1049-1055. DOI： 10.19401/j.cnki.1007-3639.2025.11.007.

摘要

背景和目的：

唾液腺导管癌（salivary duct carcinoma，SDC）是一组少见且具有高度异质性的疾病，组织学特征与乳腺导管癌高度类似，好发于中老年男性的腮腺，复发和转移率较高，预后较差。目前关于SDC的临床资料较少。本研究旨在评估SDC患者的临床特征并探讨影响预后的高危因素，为临床医师提供参考。

方法：

回顾性收集2012—2024年天津医科大学肿瘤医院和南开大学医学院附属天津市口腔医院收治的原发性SDC患者的临床资料。纳入标准：① 诊断为原发SDC的患者；② 可查询到美国癌症联合会（American Joint Committee on Cancer，AJCC）分期。排除标准：① 患者同时患有其他恶性肿瘤；② 病历信息缺失或不完善；③ 因其他疾病死亡；④ 两所医院的重复病例。检索的信息包括流行病学数据（性别、年龄）和临床数据（诊断时间、肿瘤情况、治疗方案、复发转移情况、病理学资料）。使用Kaplan-Meier法进行生存分析，并通过单因素COX比例风险回归模型分析预后相关因素。本研究通过南开大学医学院附属天津市口腔医院医学伦理委员会的审批（伦理批号：PH2023-B-016）并豁免患者知情同意。

结果：

本研究共纳入87例原发性SDC患者，其中77%为男性，69%原发于腮腺，29.9%原发于颌下腺，另有1例原发于鼻腔小唾液腺。49.3%的患者合并颈淋巴结转移。全组中位总生存期（overall survival，OS）为31.2个月，中位无进展生存期（progression-free survival，PFS）为20.3个月，5年OS率为52.6%。腮腺原发的5年OS率为60%，好于颌下腺的32.9%。85例接受手术治疗的患者中，有65.9%同时接受了原发灶切除及颈部淋巴结清扫术。术后49例患者接受了术后放疗。在随访过程中，46%的患者出现复发或转移，常见转移部位为肺和骨。接受术后放疗组的中位OS和局部无进展时间比未接受放疗的患者长，但差异无统计学上意义。

结论：

SDC是一类好发于中老年男性的腮腺恶性侵袭性疾病，其淋巴结转移率较高，患者预后较差。临床上建议对SDC患者进行彻底的原发灶切除术和颈淋巴结清扫术，并联合术后辅助放疗。靶向治疗和免疫治疗的价值值得进一步探索。

Abstract

Background and purpose:

Salivary duct carcinoma (SDC) is a group of rare and highly heterogeneous diseases. It predominantly arises in the parotid glands of middle-aged and elderly males

with high rates of recurrence and metastasis

as well as a poor prognosis. Currently

there is a lack of clinical data on SDC. This study aimed to evaluate the clinical characteristics of SDC patients and explore high-risk factors affecting prognosis

so as to provide clinical references for physicians.

Methods:

Clinical data of patients with primary SDC who were admitted to Tianjin Medical University Cancer Institute and Hospital and Tianjin Stomatological Hospital Affiliated to Nankai University School of Medicine from 2012 to 2024

were collected retrospectively. Inclusion criteria: ① patients diagnosed with primary SDC; ② availability of American Joint Committee on Cancer (AJCC) staging data. Exclusion criteria: ① concurrent other malignant tumors; ② incomplete or missing medical records; ③ death due to non-SDC causes; ④ duplicate cases from the two participating hospitals. Data retrieved encompassed epidemiological information (gender

age) and clinical details (time of diagnosis

tumor characteristics

treatment regimen

recurrence and metastasis status

and pathological data). Survival analysis was performed using the Kaplan-Meier method

and factors related to prognosis were explored through univariate COX proportional hazards regression model analysis. This study was approved by the Ethics Committee of Tianjin Stomatological Hospital Affiliated to Nankai University School of Medicine (ethics number: PH2023-B-016)

and patient informed consent was waived.

Results:

A total of 87 patients with primary SDC were included in this study

among whom 77% were male

69% had primary lesions in the parotid gland

29.9% in the submandibular gland

and one patient had a primary lesion in the minor salivary gland of the nasal cavity. 49.3% of the patients had concurrent cervical lymph node metastasis. The median overall survi

val (OS) of the entire group was 31.2 months

the median progression-free survival (PFS) was 20.3 months

and the 5-year OS rate was 52.6%. The 5-year OS rate for tumors originating from the parotid gland was 60%

which was better than the 32.9% for those originating from the submandibular gland. Among the 85 patients who received surgical treatment

65.9% underwent both resection of the primary tumor and neck dissection. Postoperative radiotherapy was administered to 49 patients. During the follow-up period

46% of the patients developed recurrence or metastasis

with lung and bone metastases being the most common. The median OS and local progression-free time in the postoperative radiotherapy group were significantly longer compared with those in the group without radiotherapy

however

the difference was not statistically significant.

Conclusion:

SDC is a malignant and aggressive disease that predominantly occurs in the parotid glands of middle-aged and elderly males

with a high rate of lymph node metastasis and poor prognosis. Clinically

it is recommended that patients with SDC undergo radical resection of the primary lesion and cervical lymph node dissection

combined with postoperative adjuvant radiotherapy. Targeted therapy and immunotherapy are worthy of further exploration.

关键词

Keywords

references

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