| Abstract | U ovom se radu provelo istraživanje o pojavnosti tumora žlijezda slinovnica u obliku retrospektivne analize baza podataka iz sustava IBIS i elektroničkog sustava Kliničkog zavoda za patologiju i patološku anatomiju od 2008. do 2018. godine pri KBC-u Rijeka. Cilj je rada bio prikazati koliki je bio ukupan broj ispitanika, te pojavnost tumora s obzirom na spol, dob, lokalizaciju i vrstu tumora. Određivao se recidiv benignih tumora, a kod zloćudnih analizirala se lokalizacija, gradus, regionalne i udaljene metastaze. Na kraju, istraživalo se korištenje dijagnostičke metode imunohistokemije te način liječenja (kirurško liječenje te radioterapija). Ukupno je bilo 96 ispitanika. Od toga su 41.7% bili muškarci, a 58.3% žene. Srednja dob ispitanika bila je 58.4 godine, mlađih od 25 godina bilo je 3.1%. Raspon ispitanika sa zloćudnim tumorom je min = 66 godina, a max = 99 godina. Najčešća lokalizacija je doušna žlijezda (81.3%), i to površni režanj (61.5%). Benigni se tumor javlja u 90 ispitanika, a maligni tumor u 6 ispitanika. Najčešće pojavljivani dobroćudni tumor je pleomorfni adenom (67.7%), dok je maligni, mukoepidermoidni karcinom (50.0%). Maligni potencijal imaju svi maligni tumori te 5.2% benignih tumora. Dokazano je da je 5.2% benignih tumora kasnije recidiviralo. Svi su benigni tumori (pleomorfni adenom). Nizak gradus ima 50% malignih tumora, 16.7% srednjih gradus, 33.3% visoki gradus. Svi su maligni tumori (n = 6) dali metastaze. Njih 50% u obližnje organe, a ostalih 50% u udaljene organe. Limfni su čvorovi bili zahvaćeni u 66.7% malignih tumora. Imunohistokemija se koristila u dokazivanju jednog mioepitelioma te u dijagnosticiranju acinocelularnog karcinoma. Terapija je u svih tumora bila kirurška ekscizija tumora s okolnim tkivom (100%), a kod malignih tumora se u 83.3% slučajeva koristila postoperacijska radioterapija.
Ovim istraživanjem dokazalo se kako su tumori žlijezda slinovnica izrazito rijetki. Pojavnost je češća u žena, te se u puno većem broju pojavljuju benigni od malignih tumora. Nadalje, najčešći je tumor bio pleomorfni adenom, a najčešći maligni tumor mukoepidermoidni karcinom, što se poklapa sa spoznajama iz recentne literature. Prosječna dob pojavnosti tumora bila je oko 60 godina, a prosječna dob pojavnosti malignih tumora 78 godina. U istraživanju se pokazalo da postoji i recidiv kod benignih tumora te da se najčešći recidiv javlja u pleomorfnom adenomu. Oni ujedno skrivaju i maligni potencijal. Kod malignih tumora, tri su imala niski gradus. Metastaze daju svi maligni tumori. U ovom su istraživanju dva pacijenta imala adeonidni cistični karcinom, koji bez obzira na prisutnost metastaza i pozitivnih limfnih čvorova ima dobro petogodišnje preživljavanje. Terapija je za sve tumore žlijezda slinovnica kirurška, dok je postoperacijska radioterapija korištena u pet pacijenata. To se poklapa s tehnikama liječenja u klinikama u zapadne Europe i SAD-a. |
| Abstract (english) | This paper is about the research of the incidence of tumors of the salivary glands in a retrospective analysis of a database extracted from the IBIS system and electronic systems at the Clinical Institute of Pathology from 2008 to 2018 at the University Hospital Center Rijeka. The aim of the study was to show what was the total number of respondents, and the incidence of tumors in relation to gender, age, localization, type of tumor (malignant or benign). It also determined the malignant potential of the tumor, recurrence, grade of malignancy and their locatization and lymph node involvement. Finally, the importance of immunohistochemistry diagnostic methods and treatment (surgery and radiotherapy) was also analysed.
Overall, there were 96 patients, 41.7% of them were male and 58.3% female. The mean age was 58.4 years and only 3.1% of the patients were younger than 25. The age range of patients with malignant tumors is from 66 to 99 years of age. The most common location, regardless of malignancy, is the parotid gland (81.3%) with the superficial region od the parotid gland being the most frequent localization (61.5%). Benign tumors occured in 90 patients while 6 of the patients had a malignant form. The most common benign tumor was pleomorphic adenoma (67.7%). Of all the malignant tumors, the most common was mucoepidermoid carcinoma (50%). Of all benign tumors, 5.2% had malignant potential. Relapse occured in 5.2% of all tumors. Considering the malignant potential, there were 50% of low grade malignant tumors, 16.7% in the middle range, and 33.3% high grade. All malignant tumors (all six of them) gave metastasis; half of them in nearby organs and the other half in distant organs. The most common place of metastasis were the lymph nodes (66.7%). Immunohistochemistry was used to prove one myoepithelioma and to diagnose one acinocellular cancer. The treatment of all tumors was surgical excision of the tumor with the surrounding tissue, while in malignant tumors, postoperative radiotherapy was also used.
This research has proved that these tumors are extremely rare. The incidence of tumors of salivary glands is slightly more common in women, more commonly the benign form (pleomorpic adenoma) and mucoepidermoid carcinoma (most common malignant form). The average age of the incidence of benign tumors was 60 years of age, and of malignant tumors 78 years of age. This paper also showed that cases of relapse are more common with pleomorphic adenomas, also having malignant potential. Three of the malignant tumors were low grade which means that they have a very good five-year survival prediction. All malignant tumors gave metastases. Two of the patients had adenoid cystic carcinoma with a great five-year survival regardless of the presence of metastases and positive lymph nodes. Four of the malignant tumors affected lymph nodes and according to the AJCC classification of tumors of the salivary glands belong to stage III and stage IV. Treatment for all salivary glands was surgery, while postoperative radiotherapy was used in five patients; same as the treatment in clinics in Western Europe and the United States. |
