Analysis of clinical and prognostic characteristics and risk factors of patients with adenoid cystic carcinoma of the head and neck with extrapulmonary as the initial site
10.16066/j.1672-7002.2024.05.001
- VernacularTitle:以肺外为首次转移部位的头颈部腺样囊性癌患者的临床、预后特征及危险因素分析
- Author:
Shujing ZHANG
1
;
Tingyao MA
;
Guoliang YANG
;
Xuelian WANG
;
Xiaohong CHEN
Author Information
1. 首都医科大学附属北京同仁医院甲状腺头颈外科,北京 100730
- Keywords:
Head and Neck Neoplasms;
Carcinoma,Adenoid Cystic;
Prognosis;
Risk Factors;
metastasis
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2024;31(5):273-277
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To assess the clinical profile,prognosis,and risk factors of extrapulmonary metastasis in adenoid cystic carcinoma patients.METHODS A retrospective analysis was conducted on 126 patients diagnosed with adenoid cystic carcinoma at Beijing Tongren Hospital between January 2002 and December 2020.Of these patients,21 cases had metastases outside the lungs as their initial site of metastasis,while 105 cases had lungs as the initial site of distant metastasis.In addition,clinical data of patients diagnosed with adenoid cystic carcinoma from the Surveillance,Epidemiology,and End Results(SEER)database in the United States from 2010 to 2019 were analyzed for prognosis.RESULTS Univariate analysis showed that factors such as N stage,neurological symptoms,pathological subtype,grading,Ki67,neural invasion,and p63 status were associated with extrapulmonary metastasis(χ2=5.385,9.888,20.485,15.579,8.711,5.476,5.280;all P values<0.05).Multivariate logistic regression analysis indicated that N stage,pathological grading,and neurological symptoms were correlated with an increased risk of extrapulmonary metastasis.Survival analysis indicated lower cumulative survival and progression-free survival rates in the initial extrapulmonary metastasis group(both P values<0.05).CONCLUSION The initial metastasis site in adenoid cystic carcinoma is associated with multiple factors including N stage,pathological grading,and neurological symptoms.Patients displaying a solid subtype and those accompanied by high-grade transformation are more prone to extrapulmonary metastasis.Patients with extrapulmonary metastasis as their initial diagnosis typically exhibit poorer prognosis.
