The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. The aim of the study was to analyse the epidemiological and histological differences of parotid tumours located in regions I–V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance, multicentre prospective studies conducted between 2017–2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men), were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, and facial nerve (FN) paresis were analysed for superficial (I_II) and deep (III_IV) lobes and with special regard to the tumours affecting region V. Twenty eight tumours were located exclusively in region V (1.45% total) and seventy-two tumours were found in region V exhibiting extensions to neighbouring regions (3.7% total), characterised as significantly younger and less frequent in retirees. In I–IV regions, approximately 90% of tumours were benign, with pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V, PA exceeded 75% but WT were casuistic (2/28). Incidences of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours > 4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy; however, 38% of patients showed false negative results both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumours located exclusively in region V vs. 1901 other patients and in 100 patients with V extension vs. 1829 other patients showed no clinical symptoms of malignancy binding with final malignant tumour histology as a single variable or in combination with other variables. The logistic regression models obtained in this study show strong linkage between tumour location and predictors (age, male gender, and tumour diameter) and also aimed to function as a good classifier. Our conclusion is that, despite the very clear image of the mid-cheek tumour which is easily accessible in palpation and ultrasound examination, it is necessary to improve oncological vigilance and preoperative patient preparation.
副腮腺（第五区）在组织学结构上与主腮腺组织存在差异。这一差异引发了一个假说，即该区域肿瘤的表现与腺体其他部位不同，临床观察也印证了这一点。本研究旨在分析位于I–V区的腮腺肿瘤在流行病学和组织学上的差异，特别关注第五区的独特性。为明确从临床良性表现中提示组织学恶性风险的流行病学因素，研究纳入了2017–2021年间由五所头颈外科大学科室在波兰唾液腺网络数据库框架内合作开展的多中心前瞻性研究，共包括1929例患者（1048名女性，881名男性）。研究分析了浅叶（I_II区）和深叶（III_IV区）肿瘤患者的年龄、性别、职业、居住地、肿瘤大小、临床恶性特征、组织学类型及面神经麻痹情况，并特别关注累及第五区的肿瘤。其中，28例肿瘤仅位于第五区（占总数的1.45%），72例肿瘤位于第五区并延伸至邻近区域（占总数的3.7%），这些患者特征表现为年龄显著更轻且退休人员较少。在I–IV区，约90%的肿瘤为良性，以多形性腺瘤和沃辛瘤为主。在第五区，多形性腺瘤占比超过75%，但沃辛瘤罕见（2/28例）。第五区恶性肿瘤发生率为40%，但恶性临床体征仅在肿瘤>4厘米或存在面神经麻痹时才明显。在19%临床表现为良性的患者中，影像学检查提示恶性；然而，38%的患者在临床和影像学恶性特征方面均显示假阴性结果。对28例仅位于第五区的肿瘤患者与1901例其他患者，以及100例累及第五区的肿瘤患者与1829例其他患者分别建立的逻辑回归模型显示，无论是作为单一变量还是与其他变量组合，恶性肿瘤的临床体征均与最终的恶性组织学结果无显著关联。本研究获得的逻辑回归模型显示肿瘤位置与预测因素（年龄、男性性别、肿瘤直径）之间存在强关联，并旨在成为一个良好的分类器。我们的结论是，尽管面颊中部肿瘤在触诊和超声检查中易于识别且影像清晰，但仍需提高肿瘤警惕性并加强术前患者准备。
肿瘤(癌症)患者之家