唾液腺腺样囊性癌474例临床病理分析

目的：分析474例唾液腺腺样囊性癌(adenoid cystic carcinoma, ACC)的临床病理特征。方法：回顾分析上海交通大学医学院附属第九人民医院口腔病理科诊断为原发性ACC的474例临床病理资料。采用SPSS18.0软件包对数据进行统计学处理。结果：474例ACC中,男女之比为1.03∶1(240∶234);发病年龄11~83岁,平均年龄52岁;腮腺和腭部分别是大小唾液腺中最常见的部位;病程1个月~37 a不等,平均21个月;64%的患者出现不同程度的症状;72%的患者就诊时TNM分期为Ⅱ期和Ⅲ期;组织学上,76%的患者表现为筛状/管状型。组织学类型为实体型者较筛状/管状型者更易发生颈淋巴结转移(P=0.016)。结论：ACC多见于中老年人,腮腺和腭部最常见。临床上多伴有不同程度的症状,组织学表现以筛状/管状型多见,实体型者更易发生颈淋巴结转移。     

2456例唾液腺肿瘤临床病理分析

目的探讨唾液腺肿瘤的发病、病理类型等临床特点。方法收集中山大学孙逸仙纪念医院口腔颌面外科1973年1月至2018年12月间确诊的唾液腺肿瘤病例2456例患者的相关资料,回顾分析其性别、年龄、病理类型、发病部位、良恶性构成比等特点。结果46年间收治的唾液腺肿瘤患者2456例,女性比例占41.9%,男性占58.1%,40~60岁年龄段为发病高峰,其中良性肿瘤1863例(75.9%),恶性肿瘤593例(24.1%),良恶性之比为3.1∶1。良性肿瘤构成比前2位是多形性腺瘤(58.7%)、Warthin瘤(33.6%),恶性肿瘤构成比前2位是黏液表皮样癌(27.7%)、腺样囊性癌(26.1%)。最常见的良性肿瘤多形性腺瘤的好发部位是腮腺、腭部、颌下腺,而恶性肿瘤中粘液表皮样癌则常见于腮腺和腭部的小唾液腺。本组资料中唾液腺肿瘤发病呈逐年递增的趋势,近10年病例占总病例数的53.3%。结论唾液腺肿瘤病人数量逐年增加;唾液腺肿瘤的总发生率男性高于女性;大唾液腺以良性肿瘤为主,小唾液腺恶性肿瘤多见;多形性腺瘤、Warthin瘤、黏液表皮样癌最常见;40~60岁是唾液腺良、恶性肿瘤高发年龄段。     

湖南地区5443例口腔颌面部恶性肿瘤临床分析

目的：调查湖南地区1989—2008年口腔颌面部恶性肿瘤患者发病情况及各类肿瘤的构成比。方法：对湖南地区12家大型三甲医院1989—2008年住院并经病理确诊的口腔颌面部恶性肿瘤患者的临床资料进行回顾分析。结果：患者平均年龄52.7岁,好发年龄段为41～70岁;男女性别比2.23∶1.00;口腔、唾液腺、颌骨分列口腔颌面部恶性肿瘤原发部位的前3位,口腔黏膜恶性肿瘤以舌、牙龈最多见。组织来源以上皮源性肿瘤最多,占94.9%;病理类型上,鳞癌3268例,占60.0%。唾液腺恶性肿瘤病理类型前4位依次为黏液表皮样癌、腺样囊性癌、腺癌、恶性多形性腺瘤;发病部位前3位依次为腮腺、下颌下腺、腭腺。2004—2008年口腔黏膜鳞癌患者中,有咀嚼槟榔习惯者平均年龄48.6岁,好发部位以舌、颊最为多见。结论：湖南地区口腔颌面部恶性肿瘤以41～70岁为好发年龄段,口腔黏膜恶性肿瘤好发部位以舌、牙龈最多,近10年来舌、颊部恶性肿瘤有明显升高趋势,而牙龈部则有下降趋势。     

重庆地区ABO血型与口腔颌面部恶性肿瘤关系的研究

目的 探讨重庆地区口腔颌面部恶性肿瘤的发生与ABO血型的关系。方法 以重庆医科大学附属口腔医院近5年确诊的重庆地区1054例口腔颌面部恶性肿瘤患者为研究对象,以同期健康体检人群为对照组,检测ABO血型。采用SPSS 22.0软件包中的χ²检验验证各组间的相关性,比较3种主要病种(鳞癌、腺样囊性癌、黏液表皮样癌)的OR值,判断各血型发生口腔颌面部恶性肿瘤的相对危险度。结果 口腔颌面部恶性肿瘤患者血型分布特点是O(34.2%)>A(32.8%)>B(24.6%)>AB(8.4%),与对照组血型构成比较无显著差异;O型血患者患黏液表皮样癌的相对危险性高于其他血型患者(P<0.05,OR=2.09,95%CI=1.04~4.17);男性患者中,黏液表皮样癌患者血型分布与对照组有显著差异(P<0.05),腺样囊性癌及黏液表皮样癌的O型血患者与其他血型患者构成有显著差异,为高风险人群(P<0.05, OR=3.06/3.06,95%CI=1.31~7.12)。结论 重庆地区口腔颌面部恶性肿瘤与ABO血型有关,O型血人群患黏液表皮样癌、男性中O型血人群患腺样囊性癌及黏液表皮样癌的风险性较高。     

2003—2012年上海地区口腔恶性肿瘤发病状况与时间趋势分析

目的 描述上海地区2003—2012年口腔恶性肿瘤的发病流行状况,分析其时间变化趋势,探寻病因学线索。方法 根据上海市疾病预防控制中心提供的口腔恶性肿瘤发病资料,应用Excel和SPSS 17.0软件包统计口腔恶性肿瘤的发病率、性别比及年龄别发病状况;采用年均变化百分比、Z检验和加权卡方检验,分析发病率的时间变化趋势。结果 2003—2012年,上海全市共诊断口腔恶性肿瘤新发病例4935例,发病粗率为35.8/100万,发病标率为18.8/100万,性别比为1.36∶1;中位首诊年龄为63岁,女性略大于男性。发病危险度随年龄的上升而增高。10年间口腔恶性肿瘤的粗发病率总体呈上升趋势。结论 随着上海城市老龄化的发展,口腔恶性肿瘤的发病呈上升趋势,老年群体的发病状况需要引起重视。     

唾液腺上皮性肿瘤1209例临床分析

目的：了解1990-2005年间唾液腺上皮性肿瘤的临床流行病学特点。方法：对南京大学医学院附属口腔医院1990年2月至2005年2月15年间收治的1209例唾液腺上皮性肿瘤患者进行回顾研究，对其病理类型、好发部位、年龄和性别等进行统汁分析。结果：1209例患者中，良性肿瘤与恶性肿瘤之比为1．96：1，男女之比为1：1。良性肿瘤以多形性腺瘤最多见（76．75％）．其次为Warthin瘤（14．75％）；恶性肿瘤以黏液表皮样癌最常见（34．2％），其次为腺样囊性癌（26．2％）。良性肿瘤和恶性肿瘤的好发部位相同，均以腮腺最多，腭部小唾液腺和下颌下腺分列第2位和第3位；发病年龄主要集中于20-70岁之间．结论：唾液腺上皮性肿瘤可发生于任何年龄，良性多于恶性，多形性腺瘤是其最常见的病理类型．     

星形细胞上调基因1在唾液腺肿瘤中的表达和意义

目的: 探讨星形细胞上调基因1(astrocyte elevated gene-1,AEG-1)在唾液腺肿瘤中的表达和意义。方法：免疫组化检测唾液腺良性肿瘤(多形性腺瘤)、恶性肿瘤(黏液表皮样癌和腺样囊性癌)组织中AEG-1的表达,探讨AEG-1的表达与唾液腺肿瘤临床病理特征的相关性。选取同期15例非肿瘤手术切除的正常唾液腺组织作为对照。采用SPSS10.0软件包对数据进行统计学分析。结果：肿瘤组织中AEG-1阳性率显著高于正常唾液腺组织(P=0.001),恶性肿瘤组AEG-1的阳性率显著高于良性肿瘤组织(P=0.033),晚期恶性肿瘤(T3+T4)AEG-1阳性率显著高于早期肿瘤(T1+T2)(P=0.035)。结论：AEG-1可能在唾液腺肿瘤的发生和恶变过程中起着一定作用。     

软腭原发性非特异透明细胞癌1例报告及文献复习

报告1例软腭透明细胞癌的治疗效果并复习相关文献。18岁女性患者,右上软腭处出现肿物,行“右上软腭区肿物扩大切除术”后,病理诊断为非特异性透明细胞癌,随访1年未见复发。腺源性非特异透明细胞癌是一种少见的低度恶性肿瘤,症状不明显,确诊依靠病理学检查,必要时做免疫组织化学染色。应与其他含透明细胞的肿瘤如黏液表皮样癌等相鉴别,以扩大切除治疗为主,预后较其他唾液腺肿瘤好。     

唾液腺淋巴上皮癌的研究进展

唾液腺淋巴上皮癌是原发于唾液腺的一种较为罕见的恶性肿瘤,最早于1962年由Hilderman首次报道并提出,曾有多个别名,如淋巴上皮瘤样癌、恶性淋巴上皮病变、伴淋巴样间质的未分化癌以及癌在淋巴上皮病变中。WHO头颈肿瘤分类第3版（2005年）正式将其更名为淋巴上皮癌。唾液腺淋巴上皮癌的临床诊治尚未规范。本文旨在针对唾液腺淋巴上皮癌的发病机制、临床病理特点、诊断、治疗和预后进行综述。     

BDNF、TrkB和E-cadherin在唾液腺腺样囊性癌中的表达及意义

目的 研究BDNF、TrkB和E-cadherin在唾液腺腺样囊性癌（salivary adenoid cystic carcinoma,SACC）中的表达及其与临床病理特点的关系。方法：采用免疫组织化学染色检测76例唾液腺腺样囊性癌和20例正常唾液腺组织中BDNF、TrkB和E-cadherin的表达情况,并分析其与临床病理特征之间的关系。采用SPSS17.0软件包对实验结果进行χ²检验、Wilcoxon秩和检验、Spearman相关系数检验。结果：与正常唾液腺组织相比,BDNF、TrkB在SACC组织中呈现高表达,阳性表达率分别为89.5%、92.1%;E-cadherin呈现中低表达,阳性表达率为46.1%。BDNF的表达与肿瘤临床分期、肿瘤转移显著相关（P<0.05）。TrkB的表达与肿瘤临床分期、神经侵袭、肿瘤转移显著相关（P<0.05）。 E-cadherin的表达与肿瘤病理分型、临床分期、神经侵袭、转移呈显著负相关（P<0.05）。在SACC中,BDNF表达与 E-cadherin表达无显著相关性（P>0.05）,而TrkB表达与E-cadherin表达呈显著负相关（P<0.05）。结论：BDNF、TrkB和E-cadherin的表达与SACC的临床病理特征密切相关,检测3者的表达对SACC的诊断和临床病理研究具有重要的参考价值。     

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目的    探讨舌下腺恶性肿瘤的发病情况、病理特征、治疗方式及疗效特点。方法    对1979—2010年中国医科大学附属口腔医院及中国医科大学附属第一医院收治的34例经病理确诊的舌下腺恶性肿瘤病例临床资料进行回顾性分析。结果    34例舌下腺恶性肿瘤患者中,男15例,女19例;年龄20～86岁,平均52.12岁;40～60岁年龄段为22例（64.71%）;病理类型中腺样囊性癌居首位（70.59%）;治疗方式主要是局部扩大切除+颈淋巴结清扫术;3、5、10年存活率分别为82.35%、76.47%、47.06%。结论    舌下腺恶性肿瘤女性患者发病率略高于男性;腺样囊性癌和黏液表皮样癌是舌下腺常见的恶性肿瘤;首次正确选择术式,且术后辅助放化疗是降低复发和转移的主要因素。     

International variation in the incidence of oral and pharyngeal cancer

OBJECTIVE: An accurate epidemiological profile is a crucial component of any cancer strategy. The ongoing development of population-based cancer registries provides an invaluable information resource in this regard. Examination of international incidence levels indicates substantial geographical variation. This study assesses the precise extent of such variation. BASIC RESEARCH DESIGN: The age-standardised rates (ASRs) for oral and pharyngeal cancer (OPC) were analysed for 183 registries in the IARC/WHO publication CIFC-Volume VII. RESULTS: The median annual age-standardised incidence rates were mouth (2.3 per 100,000), tongue (2.0), lip (1.2), and salivary gland (0.6); the corresponding female rates were mouth (0.8), tongue (0.7), salivary gland (0.4) and lip (0.2). A substantial level of heterogeneity existed between registries in most instances. In the case of males, the highest ASR and the inter-quartile range of ASRs were as follows--mouth (highest rate of 12.4 per 100,000; IQR 1.4 to 3.6), tongue (max. 8.0; IQR 1.1 to 2.9), lip (max. 13.5; IQR 0.3 to 2.4) and salivary gland (max. 4.2; IQR 0.4 to 0.8). Corresponding statistics for females were also recorded. Comb graphs are used to highlight the significance of specific geographical-based trends and putative aetiological factors explored. CONCLUSIONS: This study reveals substantial international variation in the incidence rates of OPC, with up to 20-fold variation between countries in annual incidence rates for individual sites. The novel presentational technique makes this information readily accessible to non-specialists and highlights the need for disaggregation in future OPC studies.     

Incidence and prevalence of salivary gland tumours in Valparaiso,Chile

Background

To determine the incidence and prevalence of salivary gland tumours in the province of Valparaíso, Chile.

Material and Methods

Retrospective review of salivary gland tumours diagnosed between the years 2000 and 2011 from four local pathology services. Information on demographics and histopathology were retrieved from the medical records.

Results

The study sample consisted of 279 salivary gland tumours. Prevalence and incidence rates per 100.000 persons were 15.4 and 2.51, respectively. Most of the neoplasms corresponded to benign tumours (70.3%). The most affected gland was the parotid gland. Pleomorphic adenoma was the most common benign tumour (53.8%) and mucoepidermoid carcinoma was the most common malignant tumour (7.2%).

Conclusions

Salivary gland tumours are uncommon neoplasms that usually arise in the parotid gland. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant tumours reported in this series. Key words:Salivary gland tumours, benign tumours, malignant tumours, salivary glands neoplasms, cancer, neoplasia.     

Changing incidence of oral and maxillofacial tumours in East Java, Indonesia, 1987–1992. Part 2: Malignant tumours

A total of 2193 tumours of the mouth and jaw diagnosed at the Laboratorium Patologi Anatomi Fakultas Kedokteran Universitas Airlangga, Indonesia from 1987 to 1992, inclusive, was studied. Malignant tumours constituted 45.3% of the lesions. Almost 71% of the malignant tumours were squamous cell carcinomas. The remainder were salivary gland tumours (21.5%) and sarcomas (4.5%). The male to female ratio for malignant tumours was 5.1:4.7. The incidence of malignant tumours per 100,000 population over the 6-year study period was 2.64. The yearly incidence seemed to increase except in 1990, when it dropped. The incidence of squamous cell carcinoma over the 6 years was 2.1. Calculation of the odds ratio suggested that people aged 40 and over are 5.8 times more likely to develop squamous cell carcinoma.     

Basal Cell Adenoma of Submandibular Salivary Gland: A Case Report and Literature Review

Background

Salivary gland tumours constitute about 3–4 % of all head and neck neoplasms. Approximately 80 % originate in the parotid gland and they are rarely present in the submandibular gland. Basal cell adenoma is a benign epithelial salivary gland tumour that appears to have unique histologic characteristics. The diagnosis of this entity must be established by histological study.

Case report

The literature revealed only four reported cases of basal cell adenoma of submandibular salivary gland. This article presents a rarely occurring basal cell adenoma as a fifth reported case in submandibular salivary gland in a 23 year old female.

Discussion

A rare case of basal cell adenoma of submandibular salivary gland is reported with clinical features, diagnosis, histopathological features and treatment modalities. When there is involvement of submandibular gland with a tumour the histopathological confirmation is mandatory instead of relying on FNAC and it must be differentiated from pleomorphic adenoma, adenoid cystic carcinoma, adenocarcinoma due to its prognostic implications.

Conclusion

Entities like basal cell adenoma can only be established by histopathological examination after excisional biopsy. The treatment done also affects the ultimate prognosis. As such the surgeon has to make his clinical decision based on many factors like history, clinical examination, histopathological examinations, radiological examination and immunohistochemistry study. No single criteria should be relied upon. We recommend to carry out genetic pattern study in a person with basal cell adenoma to rule out pathogenesis and establish a correct diagnosis of it for better understanding and prognosis.     

2489例涎腺上皮性肿瘤临床病理分析

目的:了解涎腺上皮性肿瘤的临床病理特点。方法:对2489例涎腺上皮性肿瘤临床病理资料进行统计分析。结果:涎腺恶性上皮性肿瘤840例,腺样囊性癌、黏液表皮样癌、癌在多形性腺瘤中居其前3位;涎腺良性上皮性肿瘤1649例,多形性腺瘤、Warthin瘤、基底细胞腺瘤居其前3位。涎腺恶性、良性上皮性肿瘤男女之比为1.13∶1和0.99∶1;平均发病年龄47.86岁和44.86岁;腮腺和腭部为好发部位。结论:腺样囊性癌和多形性腺瘤是最常见的涎腺恶性、良性上皮性肿瘤。     

Oral cancer at a Tasmanian tertiary referral clinic, the Royal Hobart Hospital 1996-2002

Background : The Holman Clinic at the Royal Hobart Hospital includes a multi-disciplinary head and neck clinic which functions as a tertiary referral centre for Southern Tasmania and involves Ear Nose and Throat surgeons, Oral and Maxillofacial Surgeons, Plastic and Reconstructive Surgeons, Radiation Oncologists and Medical Oncologists.
Methods : The aim of this study was to examine retrospectively the number, gender distribution, age, site of lesion, histology, mortality and treatment modalities of the oral cancers referred to the Holman clinic at the Royal Hobart Hospital. The medical histories and a database of the Holman clinic were used as the sources of data for this study. A total of 101 patients were treated for oral cancer in the Holman clinic at the Royal Hobart Hospital from 1996 to 2002. There were 64 males and 37 females.
Results : The distribution of anatomical sites of the oral cancers in this study was as follows: 36 oral tongue lesions, 17 floor of mouth, 13 lip, five retromolar trigone, five mandibular alveolus, six buccal mucosa, nine palatal and 10 minor and major salivary gland cancers. The most common site of oral cancer was the tongue (35.6 per cent), followed by the floor of mouth (16.8 per cent) and lip (12.9 per cent).
Conclusions : The majority of oral cancers were squamous cell carcinoma, except for the salivary gland cancers. The incidence of squamous cell carcinoma was between 67 and 100 per cent, depending upon the site involved. The trends found in this study are similar to those previously documented over the past 20 years.     

615例小涎腺上皮性肿瘤的临床病理分析

目的　探讨小涎腺上皮性肿瘤的临床病理特点。方法　对615例小涎腺上皮性肿瘤的部位分布、发病年龄、性别及组织学类型进行回顾性分析。结果　615例小涎腺上皮性肿瘤中腺瘤265例,癌350例,良恶性肿瘤之比为1∶1·3。良性肿瘤中以多形性腺瘤最为常见(81·1%),其次为肌上皮瘤(14·7%)。恶性肿瘤中以腺样囊性癌最常见(32·9%),其次为粘液表皮样癌(21·4%),腺癌(11·7%)。小涎腺上皮性肿瘤以腭部最为好发,分别占良、恶性肿瘤的77·0%和60.0%。腺瘤中女性患者(51·3%)稍多于男性(48·7%);小涎腺癌患者中男性(56·3%)多于女性 (43·7%)。小涎腺腺瘤患者平均发病年龄40·9岁,小涎腺癌平均发病年龄49·1岁,恶性肿瘤的发病年龄显著高于良性肿瘤(P<0·05)。结论　小涎腺上皮性肿瘤在病理类型构成比、部位、年龄、性别分布上具有其独到的特点。