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1.
黏液表皮样癌是唾液腺恶性肿瘤中最常见的肿瘤之一,而低分化黏液表皮样癌属于高度恶性肿瘤,较为少见。由于肾移植受者术后长期应用免疫抑制剂,故肾移植受者比普通人群更易发生恶性肿瘤,其中皮肤癌最为多见,而肾移植术后发生涎腺肿瘤较为罕见。本文报道了1名肾移植术后6年,患腮腺低分化黏液表皮样癌的男性患者。该患者接受了手术切除治疗后,达到出院标准,顺利出院。随访21个月后,病变无复发。  相似文献   

2.
150例涎腺癌的临床分析   总被引:1,自引:0,他引:1  
分析150例涎腺癌,发生在腮腺61例,颌下腺14例,舌下腺5例,和小唾腺70例。病理分型:癌在多形性腺瘤中49例,腺癌25例,腺样囊性癌24例,粘液表皮样癌22例,腺泡细胞癌22例,鳞状细胞癌5例,乳头样囊腺癌2例,未分化癌1例。150例涎腺癌3、5、10年生存率为80.7%、69.4%、52.1%。腺泡细胞癌和粘液表皮样癌预后较鳞状细胞癌、腺癌和未分化癌好。生存率根据部位,小唾液腺和腮腺肿瘤最高,舌下腺和颌下腺最低。术后放疗和化疗,对涎腺癌,生存率是重要的,涎腺癌复发率为27.6%,颈淋巴结转移率为9.2%。  相似文献   

3.
目的:探讨~(125)Ⅰ放射性粒子在腮腺粘液表皮样癌术后行组织间植入的治疗效果。方法:腮腺粘液表皮样癌病例36例随机分为两组,A组16例腮腺粘液表皮样癌作常规腮腺恶性肿瘤根治手术。B组20例行保留面神经腮腺并肿瘤切除术,尽量将肿瘤切除干净,然后在怀疑有肿瘤残留或安全边界不足处放置125I放射性粒子作为术后辅助治疗。两组病例在性别、年龄、UICC分期、病理分级之间均无显著性差异。术后随访,观察两组病例治疗效果。结果:A组13例有面瘫症状,4例复发;B组无一例出现面瘫症状,无一例复发。结论:腮腺粘液表皮样癌术后辅以放射性粒子植入组织内放疗疗效可靠且方法安全、操作简便,可有效降低腮腺粘液表皮样癌术后并发症和复发率。  相似文献   

4.
手术联合放射治疗伴有淋巴样间质的未分化癌的疗效分析   总被引:1,自引:0,他引:1  
目的:分析涎腺伴有淋巴样间质的未分化癌(恶性淋巴上皮病Malignant lymphoepithelial lesions,MLEL)的临床特点、发展规律治疗方法及转归。方法:收集自1989年-1997年来收治的涎腺伴有淋巴样间质的未分化癌患者共21例,其中原发于腮腺18例。对腮腺Ⅱ,Ⅲ期患者行肿专人切除+腮腺浅叶或全叶切除+面部神经保留术。对Ⅳ期患者根据情况,行腮颌颈联合根治术或腮颈联合根治术。术后2-9周内行原发灶或加同侧颈部照射,肿瘤剂量平均为52.03Gy。以寿命表法对生存率进行分析。结果;全组病例中,3/21有良性淋巴上皮病复发史,其中,第2次复发至确诊为伴有淋巴样间质的未分化癌最长2a,最短0.5a。Ⅱ,Ⅲ,Ⅳ期患者分别为8(42.9%)、3(14.3%)、10(47.6%)例。Ⅱ,Ⅲ期者均为NO。全组5年生存率达70.66%,Ⅱ,Ⅲ,Ⅳ期的5年生存率分别为86.68%、66.67%、33.3%。本组死亡5例,均为Ⅳ期,死于肿瘤复发;其中4/5例颈上、中淋巴结有转移。复发者7/21,其中5/7为Ⅳ期,N2、N3患者。复发后经治疗死亡者,最短存活7个月,最长7a。4/21有远处转移,均为T4N2MO。结论:对复发性良性淋巴上皮病患者应高度警惕其恶变。Ⅳ期患者应行腮腺全叶切除,面神经未受累者可考虑保留面神经,因同侧下颌下、颈淋巴结转移多见,建议行根治性或功能性颈清,术后放疗范围应包括原发灶和同侧锁骨上颈淋巴区。  相似文献   

5.
目的:探讨Tenascin-C(TN-C)mRNA和CD9mRNA在涎腺肿瘤的表达及其对涎腺肿瘤鉴别诊断的价值。方法:采用原位杂交技术检测10例正常涎腺组织、25例多形性腺瘤(PA)、25例腺样囊性癌(ACC)、20例黏液表皮样癌(MEC)、10例腺泡细胞癌(ACCa)中TN-CmRNA和CD9mRNA的表达。结果:TN-CmRNA在正常涎腺组织中呈阴性表达;CD9mRNA在正常涎腺组织中的阳性率为100%;TN-CmRNA、CD9mRNA在4种涎腺肿瘤中均有表达,TN-CmRNA在多形性腺瘤中的阳性表达率显著高于腺样囊性癌和黏液表皮样癌,差异具有统计学意义,而在多形性腺瘤与腺泡细胞癌中的表达差异无统计学意义。CD9mRNA在多形性腺瘤中的阳性表达率高于腺样囊性癌,差异有统计学意义,而在多形性腺瘤和黏液表皮样癌、腺泡细胞癌中的表达差异无统计学意义;在多形性腺瘤中TN-CmRNA和CD9mRNA的表达呈正相关,在腺样囊性癌、黏液表皮样癌和腺泡细胞癌中TN—CmRNA和CD9mRNA的表达无相关性。结论:TN-CmRNA和CD9mRNA与涎腺肿瘤的发生有一定相关性,对涎腺肿瘤之间的鉴别诊断有一定意义。  相似文献   

6.
目的检测癌胚抗原相关细胞黏附分子5(CEACAM5)和癌胚抗原相关细胞黏附分子6(CEACAM6)在涎腺黏液表皮样癌(MEC)组织中的表达情况,分析二者与涎腺黏液表皮样癌发生发展的关系。方法 60例黏液表皮样癌标本,以30例癌旁正常涎腺组织作对照,通过免疫组化法分别检测CEACAM5和CEACAM6在标本中的表达情况。结果 MEC组中CEACAM5和CEACAM6的蛋白阳性表达率分别为(68.3%,65%),明显高于正常涎腺组织中的表达率(40%,36.7%)(P<0.05),MEC组中CEACAM5和CEACAM6蛋白的阳性表达与MEC的分化程度、临床分期及颈部淋巴结转移密切相关(P<0.05),与患者的性别和年龄无关(P>0.05)。CEACAM5和CEACAM6在MEC组织中的阳性表达呈正相关。结论 CEACAM5和CEACAM6在黏液表皮样癌组织中的异常表达促进肿瘤的发生,均参与肿瘤的进展,联合检测可能与患者的预后密切相关。  相似文献   

7.
目的:探讨125I放射性粒子在腮腺粘液表皮样癌术后行组织间植入的治疗效果.方法:腮腺粘液表皮样癌病例36例随机分为两组,A组16例腮腺粘液表皮样癌作常规腮腺恶性肿瘤根治手术.B组20例行保留面神经腮腺并肿瘤切除术,尽量将肿瘤切除干净,然后在怀疑有肿瘤残留或安全边界不足处放置125I放射性粒子作为术后辅助治疗.两组病例在性别、年龄、UICC分期、病理分级之间均无显著性差异.术后随访,观察两组病例治疗效果.结果:A组13例有面瘫症状,4例复发:B组无一例出现面瘫症状,无一例复发.结论:腮腺粘液表皮样癌术后辅以放射性粒子植入组织内放疗疗效可靠且方法安全、操作简便,可有效降低腮腺粘液表皮样癌术后并发症和复发率.  相似文献   

8.
涎腺疾病     
腮腺肿瘤手术中冰冻活检的意义;腮腺多形性腺瘤113例临床分析;抑癌基因PTEN、p27及Ki-67在涎腺黏液表皮样癌中的表达;人涎腺腺样囊性癌神经侵袭动物模型的建立;内镜辅助诊断慢性阻塞性腮腺炎的临床应用;腮腺淋巴结炎继发化脓性腮腺炎的CT及声像图特点;微血管密度和涎腺腺样囊性癌远处转移及预后的关系;  相似文献   

9.
目的:报告10例涎腺透明细胞变异型黏液表皮样癌的临床病理及角蛋白表达特点。方法:回顾复习武汉大学口腔医学院1985~2006年收治、并经病理诊断为黏液表皮样癌的病例,确诊10例透明细胞变异型。全部病例行HE、PAS、AB—PAS、阿辛蓝和角蛋白免疫组织化学染色并随访。结果:本组病例约占同期所有涎腺MEC的4.7%(10/211),其中男女各5例,平均年龄42岁,腭部8例,舌根和腮腺各一例。镜下肿瘤主要由透明细胞组成的团块状或片状癌巢,其内混合少量非透明细胞(表皮样细胞或中间细胞),通常位于透明细胞的周边,呈逐渐的过渡。角蛋白免疫组化结果显示,CK7、CK8/18和CK19在所有病例中都呈强阳性表达,CK5/6、CK14、CK17和CK10/13大部分病例中呈局灶性或散在细胞表达。结论:透明细胞变异型黏液表皮样癌是黏液表皮样癌一种少见的变异,腭部多见。组织化学染色和CK10/13在透明细胞变异型黏液表皮样癌与非特异性透明细胞癌的鉴别诊断中有帮助。  相似文献   

10.
保存性腮腺切除术不同于经典的解剖面神经的腮腺浅叶切除。该文旨在评价保存性腮腺切除术治疗腮腺恶性肿瘤的效果。对1992~2002年间的43例腮腺癌患者进行回顾性研究。肿瘤均位于腮腺浅叶,并接受了保存性腮腺切除术。其中男16例,女27例;年龄8~84岁;16例(37%)为低分化,27例(63%)为高分化。24例在切除原发灶同时行颈淋巴清扫术,10例术后行辅助放疗;随访8~130个月,平  相似文献   

11.
小涎腺粘液表皮样癌临床病理及血管生成的研究   总被引:1,自引:1,他引:0  
目的:研究小涎腺粘液表皮样癌(MEC)的组织学分级与血管生成及临床病理因素之间的关系。方法:采用Auclair量化分级标准对77例小涎腺MEC行组织学分级。免疫组织化学S-P法检测血管内皮生长因子VEGF的表达、计数CD34标记的肿瘤内微血管密度(MVD),并行统计分析。结果:临床分期、组织学分级与肿瘤复发显著相关(P〈0.05)。MVD与组织学分级、临床分期及复发显著相关(P〈0.05)。VEGF表达与MVD呈正相关(P〈0.05),与肿瘤复发无明显相关。结论:应用Auclair量化分级标准对小涎腺MEC行组织学分级及计数MVD有助于判断肿瘤的生物学行为。  相似文献   

12.
OBJECTIVE: Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of salivary glands with a widely diverse biologic behavior that is correlated with the histological grade of the tumor. The purpose of this study was to evaluate the clinical outcomes of MEC of minor salivary glands in a group of 16 patients, who were treated in our clinic, and to discuss the management of this carcinoma. MATERIALS AND METHODS: Between 1985 and 2000, 16 patients with MEC of minor salivary glands were treated in the Clinic of Oral and Maxillofacial Surgery of the 'G. Papanikolaou' General Hospital, in Thessaloniki. The age range was 16-65 years. The distribution of the primary sites was: hard plate (one), soft palate (two), hard and soft palate (three), hard and soft palate with spread in paranasal sinus and nasal cavity (one), buccal mucosa (three), hard palate, alveolar process and buccal mucosa (two), and retromolar triangle (our). The tumors were clinically staged according to the tumor nodes metastase (TNM) system (Seifert, 1991). All patients were treated radically with surgery. The surgery was combined with radiotherapy in nine patients. Radiotherapy was delivered using Co-60. Doses ranged from 50 to 60 Gy and the duration of the therapy ranged from 25 to 35 days. Immunohistochemical assay of the expression of the Ki-67 antigen was performed on a subset of 15 cases. RESULTS: The mean follow-up range was 4-14 years. From the 16 patients with MECs 10 (62.5%) were alive and five (35.6%) had died from the disease. Four patients were free of the disease for more than 5 years (range 8-14), five patients were free of the disease for 5 years and one patient was free of the disease for 4 years. One patient lived more than 10 years and died from another cause. Local recurrence developed in one patient 10 years after the initial treatment. Lymph node metastases occurred in one patient within the first year after the initial surgical treatment. Distant metastases (two in bones and one in lungs) occurred in three patients within 2 years after completing the treatment. The Pearson chi-square statistical analysis was used for comparing the Ki-67 values in correlation with histological grade of the tumors. The Ki-67 expression was only 1% in low-grade MECs, while in intermediate-grade tumors it was estimated between 3 and 4%. The high-grade tumors had increased expression (10%) of tumor cells. CONCLUSION: Complete surgical excision is the treatment of choice for MECs. Adequate excision is important in all grades of tumors. Prognosis of MECs is a function of the histological grade, adequacy of excision and clinical staging. The immunohistochemical study of Ki-67 expression may provide additional prognostic information for this tumor.  相似文献   

13.
The purpose of this paper is to review our experience with mucoepidermoid carcinoma (MEC), a rare tumour in minor salivary glands, in a small series of paediatric patients. A retrospective analysis of minor salivary gland tumours seen by one surgeon from March 1991 to December 1999 was undertaken. A total of 58 cases were identified and of these, five (9%) occurred in children. There were 23 cases of MEC, four (17%) of which occurred in patients under the age of 18 who presented with T1 or T2N0M0 low- to intermediate-grade MEC of the palate and adjacent structures. These patients form the basis of this study. All patients were treated with wide local excision, obtaining tumour-free margins, and followed for a mean number of 58 months. None of these tumours invaded bone and resection of bone was not performed in any case as the periosteum was intact and the tumours were low to intermediate grade. To date, all patients remain free of disease. One patient who went elsewhere for treatment, was treated with local resection only, and has also experienced no recurrence. Wide local excision is the treatment of choice for low to intermediate grade MEC of the minor salivary glands in paediatric patients.  相似文献   

14.
Mucoepidermoid carcinoma (MEC) is an infrequent malignant neoplasm that originates most commonly in the salivary glands. The present study aimed to provide new information on prognostic factors in patients with salivary gland MEC. A retrospective analysis of the medical records of patients diagnosed with primary salivary gland MEC between 2003 and 2010 was conducted. The incidence of MEC in the minor salivary glands (62.2%) was almost twice that in the major salivary glands (37.8%). The most frequently affected sites were the parotid gland and palate. Lymph node metastasis was reported more frequently in male than female patients (P = 0.02), in high-grade than low/intermediate grade lesions (P < 0.001), and in lesions involving the submandibular gland (P < 0.001). The disease-free survival (DFS) at 5 years was 80.47%, with rates of 98.0%, 86.5%, and 38.5% for low-, intermediate-, and high-grade tumours, respectively. Among various clinicopathological factors, the only independent prognostic factor was histological grade (P < 0.001). Primary tumour site and histological grade are two important factors affecting cervical lymph node metastasis. Histological grade is the only independent factor affecting survival beyond tumor lymph node metastasis (TNM) staging in salivary gland MEC. Further advances in therapy are needed to improve the outcomes for patients with high-grade lesions.  相似文献   

15.
Mucoepidermoid carcinoma (MEC) is the most common malignancy of the salivary glands. The clinical behaviour of MEC is largely unpredictable, ranging from indolent tumour growth to highly aggressive metastatic spread. The objective of this study was to determine the clinicopathological predictors of recurrence and survival in patients with head and neck MEC. The medical records of 64 patients who underwent surgical treatment for head and neck MEC between 1982 and 2010 were reviewed. The main outcome measures were disease-free survival (DFS) and overall survival (OS). Clinicopathological parameters evaluated were age, sex, anatomical subsite, histological grade, tumour stage, tumour size, adjuvant therapy, and nodal and margin status. For the entire cohort, the 5-year DFS was 82.8% and the 5-year OS was 67.2%. Histological grade and tumour subsite were statistically significant predictors of OS. Furthermore, tumour stage and nodal status were statistically significant predictors with respect to OS. Advanced tumour stage, high histological grade, submandibular/sublingual localization, and positive nodal status were independent predictors of the prognosis in patients with head and neck MEC. Further studies into the molecular biology of MEC are needed in order to provide new therapeutic strategies for patients with locally aggressive and highly metastatic carcinomas.  相似文献   

16.
Calcifications in mucoepidermoid carcinoma (MEC) of the salivary glands are considered to be exceptionally rare and are often associated with high-grade tumors. This study reviewed 30 cases of MECs to access the frequency of calcifications and the clinical profile of the patients and histopathologic aspects of the tumors. In total, 6 cases of calcifications (20%) were identified. Five patients were women and 1 was a man, patients' ages ranged from 22 to 69 years old, and calcifications were found in conventional and clear cell-type MECs. Areas of calcification showed positivity for periodic acid-Schiff and mucicarmine, supporting the hypothesis that they originate from the precipitation of mucous secretion. The presence of calcifications in MECs was independent of the histologic grade of the tumors and the histopathologic variants. Calcifications in salivary MECs may not be as rare as previously mentioned in the literature and may be not associated with high-grade tumors.  相似文献   

17.
舌根恶性多形性腺瘤双颈淋巴结转移(附病例报告)   总被引:1,自引:1,他引:0  
目的:研究舌根恶性多形性腺瘤(MPA)双侧颈淋巴结内癌转移的临床表现、诊断、治疗及预后。方法:对舌根恶性多形性腺瘤双侧颈淋巴结内癌转移病例,分析其临床表现、影像学表现、诊疗过程及组织病理学特征,并进行文献回顾。结果:本文病例为老年男性,首诊症状为颈侧上部无痛肿物,鼻咽镜检查发现舌根无痛性肿物,钳取活检为中分化鳞状细胞癌,行舌根肿瘤扩大切除及双侧改良根治性颈淋巴清扫术,术后病理为舌根恶性多形性腺瘤,恶性成分为鳞状细胞癌,可见淋巴管内瘤栓,双侧Ⅰ、Ⅱ、Ⅲ区颈淋巴结内癌转移(18/42)。术后放疗50Gy,随访1年,未见肿瘤复发与转移。结论:舌根MPA极罕见,双侧颈淋巴结内癌转移病例,经文献检索未见报告。手术彻底广泛切除原发灶并行颈清扫术,辅以放疗,预后良好。  相似文献   

18.
ObjectivesThe aberrant expression of mucins and mucin-type carbohydrates has been described in many types of cancer, including mucoepidermoid carcinoma (MEC), a malignant salivary gland tumor. In this study, we examined the aberrant expression patterns of mucins (MUC1, MUC4, MUC5AC and MUC5B), simple mucin-type carbohydrate antigens (Tn, sialyl-Tn and T) and mature carbohydrate antigens (Lewisa and sulfo-Lewisa antigens) in MEC originating from the parotid gland, which normally does not secrete mucins.DesignWe conducted an immunohistochemical study to investigate the presence of mucins and carbohydrates in 24 MEC samples originating from the parotid gland and in surrounding normal tissue of the same gland in comparison 6 samples of normal salivary glands. The expression levels were compared with respect to the histological grading. Furthermore, 24 MEC samples from non-parotid salivary glands were included.ResultsWe observed loss of topology of membrane-bound MUC1 and MUC4, and de novo expression of MUC5AC, MUC5B and sialyl-Tn in MEC that originated in the parotid gland. Furthermore, mucins MUC1, MUC4 and carbohydrate antigens Tn, sialyl-Tn, T, Lewisa and sulfo-Lewisa were overexpressed in MEC samples compared to surrounding normal salivary gland tissues. MUC1 was expressed in both low- and high grade MECs, whereas MUC4 was not expressed in high grade MECs of the parotid gland.ConclusionDuring the development of MEC in the parotid gland, the genes for gel-forming secretory mucins are switched on. Besides these MEC tissues overexpress short oligosaccharides, suggesting that the glycosylation machinery is altered.  相似文献   

19.
涎腺肌上皮癌的生物学行为及治疗   总被引:28,自引:1,他引:28  
为了总结涎腺肌上皮癌的生物学行为及有效治疗,作者对19例涎腺肌上皮癌患者进行临床分析,其临床特点为:发病部位以腮腺为最常见,其次为腭部;部分肿瘤生长迅速,广泛侵犯周围组织;颈部淋巴结转移率不很高,但血行性转移率高;治疗后极易复发;患者预后差。其生物学行为属高度恶性肿瘤。治疗以根治性切除为主,原则上不作选择性颈淋巴清扫术;放射治疗不敏感。对于局限性肿瘤复发灶及时手术可获得较好的效果。  相似文献   

20.
目的:研究HER-2/neu及β-catenin在粘液表皮样癌中的表达,探讨其在粘液表皮样癌中的作用及其临床意义。方法:应用免疫组织化学S-P法检测42例粘液表皮样癌及10例正常涎腺组织中HER-2/neu及β-catenin的表达。结果:粘液表皮样癌中HER-2/neu和β-catenin的阳性表达率分别为69.05%(29/42)和35.71%(15/42)与正常对照组存在显著性差异(P&lt;0.05)。HER-2/neu和β-catenin的阳性率在不同分化程度的粘液表皮样癌中存有差异(P&lt;0.05),β-catenin的表达与是否存在淋巴结转移有显著性关系(P&lt;0.05)。结论:HER-2/neu及β-catenin的表达与粘液表皮样癌的病理分级有显著相关性,β-catenin与肿瘤转移明显相关,它们可作为判断肿瘤预后的辅助指标。  相似文献   

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