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Multivariate Analysis of the Risk Factors Influencing Re-recurrencein the Patients with Recurrent Parotid Pleomorphic Adenoma

Author: LiuJie
Tutor: ZhaoYunFu
School: Second Military Medical University
Course: Clinical Stomatology
Keywords: Recurrent pleomorphic adenoma Surgery Secondary recurrence Parotid PCNA Muc1 Bcl-2 Bax
CLC: R739.8
Type: Master's thesis
Year: 2010
Downloads: 44
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Abstract

Background: pleomorphic adenoma (pleomorphic adenoma, PA) is the most common salivary gland tumors, the criticality tumor is composed of a variety of different morphological appearance of epithelial cells and myoepithelial cells. PA was slow-growing, most commonly occurs in the parotid gland, accounting for 60-70% of all parotid gland tumors. It is reported that the annual incidence rate 2.40-3.05/10 million people, of which about 80% occur in the parotid gland. PA was usually slow growth, when the initial issuance of the use of surgical resection, postoperative higher recurrence rate and malignant tendency is cause for concern. Parotid PA recurrence, recurrent pleomorphic adenoma (recurrent pleomorphic adenoma, RPA) surgery is likely to cause facial nerve damage, and a very high rate of secondary recurrence. Many scholars believe that the parotid PA recurrence, especially multinodular growth or recurrence of malignant tendency, not only with clinical factors inherent biological characteristics of the PA. However, the results of the present study is not yet clear relationship between clinical prognosis and tumor biological characteristics. The study analysis the parotid RPA after secondary recurrence rate and impact of secondary risk factors for recurrence. Methods: A retrospective analysis of the clinical and pathological features of patients with parotid RPA, application life table method after secondary recurrence rate. PCNA, Muc1, Bcl-2 and Bax protein expression in the recurrence group and recurrence group detected by immunohistochemistry SP method, the expression between the two groups were compared by using the x2 test. By the Kaplan-Meier method of secondary recurrence of various clinical factors and PCNA. Muc1, Bcl-2 and Bax indicators were univariate statistical analysis, multivariate analysis using Cox proportional hazards regression model screening secondary risk factors for recurrence. Statistical analysis was performed using SPSS13.0 software package. Results: 1,46 patients parotid RPA patients, male 20 cases (43.48%) and 26 females (56.52%), aged 15-74 years old, with a median age of 37.5 years. 46 cases, 13 cases partial resection (seven cases of recurrence, accounting for 53.85%), 21 cases of superficial parotidectomy surgery (9 relapsed, accounting for 42.86%), 12 cases of parotid lobectomy (2 cases of recurrence , 16.67%). Secondary recurrence rate after five years (28.38 ± 7.71)% and (65.57 ± 11.02)% in 10 years, 15 years (74.18 ± 11.13)%. The relapse rate was significantly higher with increasing time. Detected by immunohistochemical SP method the PCNA, Muc1, Bcl-2 and Bax protein expression in surgical specimens of 46 cases of patients with parotid RPA, x2 test results show Muc1 protein expression differences in the recurrence group and recurrence group has statistically significant (P lt; 0.05), the high expression of Muc1 might affect risk factors for the parotid RPA postoperative relapse. 3, Kaplan-Meier method univariate analysis showed that the parotid RPA patients the surgical approach, the number of tumor nodules and Muc1 protein expression and postoperative secondary recurrence is closely related, with statistical significance (P lt; 0.05). The line the parotid full leaf excision RPA patients between 5 to 10 years of secondary recurrence rate than local expansion of low resection or parotid superficial lobe resection in patients with the RPA; the secondary postoperative recurrence RPA multinodular were significantly higher than in patients with single nodule; Muc1 showed high expression secondary recurrence rate the RPA after surgery of the lower expression. Cox proportional hazards regression model screening results show that the the RPA number of tumor nodules in patients the way of RPA Patients and Muc1 protein expression levels were statistically significant, they may affect the RPA postoperative secondary recurrence independent risk factors. This result is also reflected, the univariate analysis the results of the present study. Conclusion: The the secondary parotid RPA postoperative recurrence rate with time has increased year by year, therefore, should be carried out on patients with long-term follow-up after surgery. For reducing the likelihood of relapse and to prevent the occurrence of facial paralysis, the preservation of the facial nerve of the parotid full leaf expansion of resection is the right choice, especially for the RPA was multinodular growth or Muc1 was highly expressed in patients, more should line completely thorough the resection .

Multivariate Analysis of the Risk Factors Influencing Re-recurrencein the Patients with Recurrent Parotid Pleomorphic Adenoma

Abstract

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