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1、头颈部皮脂腺癌的诊断与治疗探讨作者：黄健男，占顺堂，邹苑斌，张学辉，赵晓明，彭树文，郑明奋【关键词】皮脂腺癌；头颈部；病理学 ［摘要］目的探讨头部皮脂腺癌的诊断与治疗，进一步提高诊治率。方法收集28例经病理证实的头颈部皮脂腺癌患者的临床资料，其中眼睑皮脂腺癌10例；腮腺皮脂腺癌2例；外耳道皮脂腺癌5例；颌面部皮脂腺癌7例；颈部皮脂腺癌4例，颈部淋巴结转3例，采用手术、放疗、化疗等综合治疗。结果皮脂腺癌确诊需要免疫组化检测，而罕见的腮腺皮脂腺癌还需和透明细胞癌、黏液表皮样癌和腺泡细胞癌鉴别，全组病例5年以上随访，5年生存率
2、可达71.4%（20/28），5年内原发灶复发10例，其中，3例伴有区域淋巴结转移而再次手术，4例失访（按死亡计）；2例死于远处转移；2例死于其他疾病。结论皮脂腺癌多发于头面部尤其是眼睑，罕见的腮腺皮脂腺癌易被临床忽视，主要复发在局部病灶，较少发生淋巴结转移，死亡原因主要为远处转移，早期诊断、早期根治性综合治疗是提高5年生存率的关键。 ［关键词］皮脂腺癌；头颈部；病理学 DiagnosisandtreatmentofsebaceouscarcinomaintheHeadandNeck(Reportof28Cases)
3、 ［Abstract］ObjectiveTostudythediagnosisandtreatmentofsebaceouscarcinomainHeadandNeck.MethodsCollecting28casesainHeadandNeckeatusin5cases,maxillofacialin7cases,neckportionin4cases,necklymphnodemetastasisin3cases.Theyistrytherapy.ResultsDiagnosisofsebaceouscarcinoma
4、demandedimmunohistochemistry(IHC),andrareparotidsebaceouscarcinomaa,grumeepidermiscarcinomaandaciniccellcarcinomainpathology.ByFolloaryfocusrecurrencein10cases,inphnodemetastasisedoperationonceagain.Fourcaseslostmunication(countfordeath);2casesdiedofdistantmetasta
5、sis;2casesdiedofotherdiseases.ConclusionThesebaceouscarcinomamostlyoccurredinHeadandneck,especiallyineyelid,rareinparotid,ostlypresentedinprimaryfocus,andnecklymphnodemetastasisismuchless.Thecauseofdeathmainlyisdistantmetastasis.Itiskeypointthatforepartdiagnosisan
6、dtreatmentcanpromotesurvivalratefor5years. ［Keya;headandneck;pathology INTRODUCTION Sebaceouscarcinomaisararemalignanttumor,oreineyelidthanotherportion,andmoreinoldageman.From1985to2001,28ofpatientsaonMaterialsTentincluding20malesand8females;ageranged:＞50yearso
7、ldin22cases,＜50yearsoldin6cases;ill-period:at＞4yearsin16cases,2yearsin6cases,1～3monthsin6cases.oneofallainHeadandNeck,eatusin5cases,maxillofacialin7cases,neckportionin4cases,necklymphnodemetastasisin3cases. 1.2DiagnosisandtreatmentmethodsAllofthese30casesathrough
8、paraffinsectionandEMA,S-100,CK/H,ACTINofIHCstainingexamination.Allofthesepatients,primaryfocusoftumorsphnodedissectionin3cases,preventingnecklymphnodedi
