OBJECTIVE: To study the diagnosis and treatment of parotid Lymphoepithelioma-like carcinoma (LELC), and improve the rate of the diagnosis and treatment. METHOD: Eighteen cases with parotid LELC confirmed pathologically were collected in our department, and the clinical presentation, diagnosis, treatment and prognosis were retrospectively summarized and analyzed from 1982 to 2002. RESULT: All of these LELC patients were found in unilateral side. All cases received Epstein-Barr virus serological test except 2 cases because of refusing, and the testing result displayed: EBV-VCA-IGA positive rate in 93% (15/16); EBV-EA-IGA in 75% (12/ 16); EBV-DNA enzyme in 63% (10/16). Of 16 cases with facial nerve reserved, parotid superficial lobectomy were undertaken in 6 cases, resecting a majority of parotid in 5 cases, whole lobectomy in 5 cases. Facial never resection and whole lobectomy in 2 cases due to facial nerve trunk involved. Functional neck lymph dissection in superior and middle part was undertaken in 14 cases and radical neck lymph dissection in 4 cases, total neck lymph node metastasis rate was 67% (12/18). All of patients received radiotherapy to 50-70 Gy. The follow up were over 1 year, and local recurrence occurred in 2-4 years after operation for 4 cases and had to undergo reoperation. The 1, 3, 5 years survival rates of the 18 cases were 94% (17/18), 72% (13/18) and 50% (9/18), respectively. The chief Causes of death were distant metastasis and local recurrence. CONCLUSION There maybe be close relationship between occurrence of LELC and Epstein-Barr virus infection. Its histopathologic feature is similar to undifferentiated nasopharyngeal carcinoma and nasopharynx biopsy must be demanded before confirming diagnosis for eliminating metastasis focus. The neck lymph node metastasis rate of LELC is high and local invasion is strong. It is important to undergo enlarged local resection, neck lymph dissection and postoperative radiotherapy.
Adolescent ; Adult ; Aged ; Antigens, Viral ; analysis ; Carcinoma ; diagnosis ; surgery ; virology ; Female ; Herpesvirus 4, Human ; pathogenicity ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Parotid Neoplasms ; diagnosis ; surgery ; virology ; Prognosis ; Retrospective Studies ; Young Adult

Objective:To develop the discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome(AIDS) patients and test the reliability and validity of the questionnaire.Methods:Based on the literature review and semi-structured interviews to clarify the operational definition of discrimination for HIV/AIDS and develop the item pool. The questionnaire was developed though 2 rounds Delphi consultation and a pilot test. A total of 410 HIV/AIDS patients in Shanghai Public Health Clinical Center of Fudan University from June to December 2020 were selected to investigate the questionnaire, item analysis was used to screen items. SPSS 22.0 software was used for reliability test and exploratory factor analysis, the AMOS 21.0 software was used for confirmatory factor analysis to test the reliability and validity of the questionnaire.Results:The questionnaire consisted 2 dimensions(external discrimination and internal discrimination) and 10 items. Exploratory factor analysis showed that two common factors were extracted from the frequency of discrimination and the degree of negative psychological impact of discrimination experience on patients, and the cumulative variance contribution rates were 48.367% and 55.403%, respectively. The confirmatory factor analysis on the frequency of discrimination showed that Chi square degree of freedom ratio ( χ2/ df) was 2.831, P<0.05, root mean square of approximation error (RMSEA) was 0.093, goodness of fit index (GFI) was 0.928, comparative fit index (CFI) was 0.925, incremental fit index (IFI) was 0.926; the confirmatory factor analysis on the negative psychological impact of discrimination experience on patients showed that χ2/ df was 1.740, P<0.05; RMSEA was 0.076, GFI was 0.925, CFI was 0.936, IFI was 0.938. The content validity of the questionnaire was 0.9. The Cronbach α coefficientof questionnaire was 0.811, and the test-retest coefficient was 0.862 ( P<0.01). Conclusions:The discrimination experience questionnaire for HIV/AIDS patients has good reliability and validity, and it can be used to measure the discrimination for HIV/AIDS patients.