[Clinical characteristics and treatment of myoepithelial carcinoma of head and neck].

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of myoepithelial carcinoma of the head and neck. Method:The clinical data of 59 patients with head and neck myoepithelial carcinoma admitted from January 2012 to October 2018 were analyzed retrospectively. The data was analyzed with SPSS 21.0 statistical software. Result:The follow-up period was 6 to 131 months. The mean follow-up time was 36 months. One patient（1.7%） was lost to follow-up, 17 patients（28.8%） had postoperative local recurrence, 8 patients（13.6%） had distant metastasis, and 5 patients（8.5%） had cervical lymph node metastasis; 14 patients（23.7%） died. The 1-, 3-, and 5-year cumulative survival rates were 92%, 73%, and 62%, respectively. Survival rate curves of different treatment methods were significantly different by Gehan method（P<0.05）. Compared between the two groups, there was significant difference between surgery alone and surgery plus radiotherapy than radiotherapy alone and chemotherapy alone（P<0.05）. There was no significant difference between the other two treatment methods. Multivariate logistic regression analysis showed that tumor location, clinical stage and survival status and local recurrence rate were significantly correlated（P<0.05）, but gender, age and survival status and local recurrence rate were not significantly correlated（P>0.05）. Conclusion:The incidence of myoepithelial carcinoma is low, and the clinical manifestations and imaging studies lack specificity. The tumor is prone to local recurrence, invasive, and has a high incidence of distant metastasis. It is a highly malignant tumor. Surgical treatment is preferred and the requirements for first surgery are high, and major salivary glands and advanced tumors（stage Ⅲ-Ⅳ） are risk factors for survival and local recurrence. Early diagnosis and early treatment can significantly improve the survival rate of patients, reduce the local recurrence rate of tumors, and improve the prognosis of patients.目的：探讨头颈部肌上皮癌的临床特点、诊断、治疗及预后。 方法：回顾性分析59例头颈部肌上皮癌患者的临床资料。应用SPSS 21.0统计软件对数据进行分析。 结果：随访时间为6～131个月，平均随访时间为36个月，1例（1.7%）失访，17例（28.8%）术后复发，8例（13.6%）远处转移，5例（8.5%）颈部淋巴结转移；14例（23.7%）死亡。1年、3年、5年累计生存率分别为92%、73%、62%。不同治疗方式生存率曲线经Gehan法检验差异显著（P<0.05）；组间两两比较，单纯手术及手术加放疗与单纯放疗及单纯化疗差异显著（P<0.05），其他两两治疗方式之间尚无显著差异。多因素Logistic回归分析显示肿瘤部位、临床分期与存活状态及局部复发率显著相关（P<0.05），而性别、年龄与生存状态及局部复发率相关性不显著（P>0.05）。 结论：肌上皮癌发病率低，临床表现及影像学检查缺乏特异性。肿瘤易局部复发，侵袭性强，远处转移发生率高，是一种高度恶性肿瘤。首选手术治疗且对首次手术的要求较高，大涎腺及晚期肿瘤（Ⅲ～Ⅳ期）为生存率及局部复发率的高危因素。早诊断、早治疗能显著提高患者生存率，降低肿瘤局部复发率，改善患者预后。.