鼻腔鼻窦腺样囊性癌的多学科综合诊治

甄宏韬

doi:10.3971/j.issn.1000-8578.2026.25.0775

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鼻腔鼻窦腺样囊性癌的多学科综合诊治

专家论坛 | 更新时间：2026-11-05

- 鼻腔鼻窦腺样囊性癌的多学科综合诊治
- Multidisciplinary Comprehensive Diagnosis and Treatment of Sinonasal Adenoid Cystic Carcinoma
- 肿瘤防治研究 2026年53卷第4期页码：237-242
- 作者机构：
- 作者简介：
  
  甄宏韬，男，博士，主任医师，主要从事鼻内镜外科和头颈外科工作，E-mail: zhtlancet@163.com，ORCID: 0000-0001-7224-7465
- 基金信息：
- DOI：10.3971/j.issn.1000-8578.2026.25.0775
  中图分类号： R739.62
- 纸质出版：2026
- 稿件说明：
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甄宏韬. 鼻腔鼻窦腺样囊性癌的多学科综合诊治[J]. 肿瘤防治研究, 2026, 53(4): 237-242.

ZHEN Hongtao. Multidisciplinary Comprehensive Diagnosis and Treatment of Sinonasal Adenoid Cystic Carcinoma[J]. 2026, 53(4): 237-242.
甄宏韬. 鼻腔鼻窦腺样囊性癌的多学科综合诊治[J]. 肿瘤防治研究, 2026, 53(4): 237-242. DOI： 10.3971/j.issn.1000-8578.2026.25.0775.

ZHEN Hongtao. Multidisciplinary Comprehensive Diagnosis and Treatment of Sinonasal Adenoid Cystic Carcinoma[J]. 2026, 53(4): 237-242. DOI： 10.3971/j.issn.1000-8578.2026.25.0775.

摘要

鼻腔鼻窦腺样囊性癌（SNACC）是除鳞状细胞癌外，发病率占第二位的鼻腔鼻窦恶性肿瘤。大多数患者在诊断时已处于疾病晚期阶段（T3~T4），伴有较高比例的神经浸润、骨浸润和前颅底受累，手术切缘阳性率高。治疗后易出现局部复发和远处转移，甚至可能发生在初次治疗后数年或数十年。影像学检查对于明确肿瘤范围具有重要价值，但确诊仍需组织活检。手术切除是SNACC目前主要的治疗方式，其中经鼻内镜手术在降低并发症和改善生活质量方面具有优势，其生存结局与开放手术相当。对于不可切除的患者，推荐采用放疗联合或不联合化疗方案。长期密切随访对于该病的全程管理十分必要。MDT能为SNACC的诊治提供核心策略。MDT模式强调精准分期与个体化治疗，通过整合各学科优势，旨在实现肿瘤控制、功能保留和生活质量改善的统一，是目前管理SNACC的最佳途径。

Abstract

Sinonasal adenoid cystic carcinoma (SNACC) is the second most common sinonasal malignancy

following squamous cell carcinoma. Most patients present with advanced stage disease (T3-T4) at the time of diagnosis

with a propensity for perineural invasion

bone invasion

anterior skull base involvement

and high probability of positive margins. After initial treatment

local recurrence and distant metastasis are common

sometimes occurring years later. Imaging studies are valuable for determining the extent of the tumor

but a pathological biopsy remains essential for a definitive diagnosis. Surgical resection is currently the primary treatment modality. Endoscopic surgery offers advantages in reducing complications and improving quality of life while providing comparable survival outcomes to open surgery. For unresectable cases

radiotherapy combined with or without chemotherapy is recommended. Long-term close follow-up is crucial for comprehensive management of the disease. A multidisciplinary team (MDT) provides the core strategy for the diagnosis and treatment of SNACC. The MDT focuses on precise staging and personalized treatment

aiming to balance tumor control

functional preservation

and quality of life improvement. It represents the optimal current management pathway for SNACC.

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references

Billroth T. Beobachtungen Über Geschwülste der Speicheldrüsen[J]. Virchows Arch Pathol Anat, 1859, 17: 357-375.

Unsal AA, Chung SY, Zhou AH, et al . Sinonasal adenoid cystic carcinoma: a population-based analysis of 694 cases[J ] . Int Forum Allergy Rhinol, 2017, 7(3): 312-320.

Castelnuovo P, Turri-Zanoni M. Adenoid cystic carcinoma[J]. Adv Otorhinolaryngol, 2020, 84: 197-209.

Ungar OJ, Vass R, Shapira U, et al . Advanced stage adenoid cystic carcinoma of the sinonasal cavity and skull base: a retrospective 20-year analysis[J ] . Int J Oral Maxillofac Surg, 2025, 54(3): 199-207.

Kuan EC, Wang EW, Adappa ND, et al . International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors[J ] . Int Forum Allergy Rhinol, 2024, 14(2): 149-608.

Chinese Anti-Cancer Association. CACA Guidelines — Malignant Tumors of the Nasal Cavity and Paranasal Sinuses[M]. Tianjin: Tianjin Science and Technology Press, 2025.

Bahig H, Ehab HY, Garden AS, et al . Long-term outcomes of modern multidisciplinary management of sinonasal cancers: The M. D. Anderson experience[J ] . Head Neck, 2023, 45(7): 1692-1703.

Jang HB, Lee DH, Lim SC. Treatment outcomes of sinonasal adenoid cystic carcinoma: a single-center experience[J]. Oral Oncol, 2025, 165: 107317.

Chang CF, Hsieh MY, Chen MK, et al . Adenoid cystic carcinoma of head and neck: A retrospective clinical analysis of a single institution[J ] . Auris Nasus Larynx, 2018, 45(4): 831-837.

Lupinetti AD, Roberts DB, Williams MD, et al . Sinonasal adenoid cystic carcinoma: the M. D. Anderson Cancer Center experience[J ] . Cancer, 2007, 110(12): 2726-2731.

Michel G, Joubert M, Delemazure AS, et al . Adenoid cystic carcinoma of the paranasal sinuses: retrospective series and review of the literature[J ] . Eur Ann Otorhinolaryngol Head Neck Dis, 2013, 130(5): 257-262.

Trope M, Triantafillou V, Kohanski MA, et al . Adenoid cystic carcinoma of the sinonasal tract: a review of the national cancer database[J ] . Int Forum Allergy Rhinol, 2019, 9(4): 427-434.

Mauthe T, Holzmann D, Soyka MB, et al . Overall and disease-specific survival of sinonasal adenoid cystic carcinoma: a systematic review and meta-analysis[J ] . Rhinology, 2023, 61(6): 508-518.

Amit M, Binenbaum Y, Sharma K, et al . Adenoid cystic carcinoma of the nasal cavity and paranasal sinuses: a meta-analysis[J ] . Neurol Surg B Skull Base, 2013, 74(3): 118-125.

Bin-Alamer O, Haider AS, Chaudhary A, et al . Adenoid cystic carcinoma (ACC) infiltrating the skull base: a systematic review of clinical characteristics and management strategies[J ] . Cancer Diagn Progn, 2022, 2(5): 503-511.

Husain Q, Kanumuri VV, Svider PF, et al . Sinonasal adenoid cystic carcinoma: systematic review of survival and treatment strategies[J ] . Otolaryngol Head Neck Surg, 2013, 148(1): 29-39.

Ishida E, Ogawa T, Rokugo M, et al . Management of adenoid cystic carcinoma o f the head and neck: a single-institute study with over 25-year follow-up[J ] . Head Face Med, 2020, 16(1): 14.

Wang Y, Ji Y, Guo L, et al . Computed tomography and magnetic resonance imaging findings contribute to differentiating solid- and nonsolid-type adenoid cystic carcinoma in maxillary sinus[J ] . J Comput Assist Tomogr, 2023, 47(6): 989-995.

Li Y, Hao D, Song X, et al . Computed tomography and magnetic resonance imaging of adenoid cystic carcinoma in the maxillary sinus: a retrospective study with radiologic-histopathologic correlations[J ] . Oral Surg Oral Med Oral Pathol Oral Radiol, 2021, 131(1): 111-121.

Cheng J, Liu Q, Wang Y, et al . Sinonasal adenoid cystic carcinoma: preoperative apparent diffusion coefficient histogram analysis in prediction of prognosis and Ki-67 proliferation status[J ] . Jpn J Radiol, 2025, 43(3): 389-401.

Amin MB, Edge SB, Greene FL, et al . AJCC Cancer Staging Manual[M ] . 8th ed. New York: Springer, 2017.

Castelnuovo P, Turri-Zanoni M, Battaglia P, et al . Sinonasal malignancies of anterior skull base: histology-driven treatment strategies[J ] . Otolaryngol Clin North Am, 2016, 49(1): 183-200.

Thompson LD, Penner C, Ho NJ, et al . Sinonasal tract and nasopharyngeal adenoid cystic carcinoma: a clinicopathologic and immunophenotypic study of 86 cases[J ] . Head Neck Pathol, 2014, 8(1): 88-109.

Huang Z, Pan J, Chen J, et al . Multicentre clinicopathological study of adenoid cystic carcinoma: A report of 296 cases[J ] . Cancer Med, 2021, 10(3): 1120-1127.

Andersson MK, Afshari MK, Andrén Y, et al . Targeting the Oncogenic Transcriptional Regulator MYB in Adenoid Cystic Carcinoma by Inhibition of IGF1R/AKT Signaling[J ] . J Natl Cancer Inst, 2017, 109(9).

Kashiwazaki R, Turner MT, Geltzeiler M, et al . The endoscopic endonasal approach for sinonasal and nasopharyngeal adenoid cystic carcinoma[J ] . Laryngoscope, 2020, 130(6): 1414-1421.

Volpi L, Bignami M, Lepera D, et al . Endoscopic endonasal resection of adenoid cystic carcinoma of the sinonasal tract and skull base[J ] . Laryngoscope, 2019, 129(5): 1071-1077.

Michel J, Fakhry N, Santini L. et al . Sinonasal adenoid cystic carcinomas: clinical outcomes and predictive factors[J ] . Int J Oral Maxillofac Surg, 2013, 42(2): 15 3-157.

Guazzo E, Bowman J, Porceddu S, et al . Advanced adenoid cystic carcinoma of the skull base - The role of surgery[J ] . Oral Oncol, 2019, 99: 104466.

Amit M, Na'ara S, Trejo-Leider L, et al . Defining the surgical margins of adenoid cystic carcinoma and their impact on outcome: An international collaborative study[J ] . Head Neck, 2017, 39(5): 1008-1014.

Mays AC, Hanna EY, Ferrarotto R, et al . Prognostic factors and survival in adenoid cystic carcinoma of the sinonasal cavity[J ] . Head Neck, 2018, 40(12): 2596-2605.

Lukšić I, Baranović S, Suton P, et al . Adenoid cystic carcinoma of the head and neck: a single-institution's analysis of 45 consecutive cases over a 29-year period[J ] . Oral Surg Oral Med Oral Pathol Oral Radiol, 2016, 122(2): 152-157.

International Head and Neck Scientific Group. Cervical lymph node metastasis in adenoid cystic carcinoma of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal: a collective international review[J]. J Laryngol Otol, 2016, 130(12): 1093-1097.

Conley J, Dingman DL. Adenoid cystic carcinoma in the head and neck (cylindroma)[J]. Arch Otolaryngol, 1974, 100(2): 81-90.

Song XM, Yang G, Tu ZW, et al . Is prophylactic neck irradiation indicated for patients with cN0 adenoid cystic carcinoma of the paranasal sinuses?[J ] . Radiother Oncol, 2022, 173: 292-298.

Hu W, Hu J, Huang Q, et al . Particle beam radiation therapy for adenoid cystic carcinoma of the nasal cavity and paranasal sinuses[J ] . Front Oncol, 2020, 10: 572493.

Mavrikios A, Goudjil F, Beddok A, et al . Proton therapy and/or helical tomotherapy for locally advanced sinonasal skull base adenoid cystic carcinoma: focus on experience of the Institut Curie and review of literature[J ] . Head Neck, 2023, 45(7): 1619-1631.

Dautruche A, Bolle S, Feuvret L, et al . Three-year results after radiotherapy for locally advanced sinonasal adenoid cystic carcinoma, using highly conformational radiotherapy techniques proton therapy and/or tomotherapy[J ] . Cancer Radiother, 2018, 22(5): 411-416.

Sulaiman NS, Demizu Y, Koto M, et al . Multicenter study of carbon-ion radiation therapy for adenoid cystic carcinoma of the head and neck: Subanalysis of the Japan carbon-ion radiation oncology study grou p (J-CROS) study (1402 HN)[J ] . Int J Radiat Oncol Biol Phys, 2018, 100(3): 639-646.

Atallah S, Marc M, Schernberg A, et al . Beyond surgical treatment in adenoid cystic carcinoma of the head and neck: a literature review[J ] . Cancer Manag Res, 2022, 14: 1879-1890.

Guazzo E, Panizza B. Management of advanced adenoid cystic carcinoma infiltrating the skull base: a contemporary review[J]. J Neurooncol, 2020, 150(3): 419-427.

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