泪腺腺样囊性癌的研究现状

泪腺腺样囊性癌是原发性泪腺上皮性肿瘤中最常见且恶性程度最高的肿瘤.近年来国内外对该病的组织学分类及病理学改变、主要临床表现、治疗手段有了新的认识;在细胞与分子生物学方面,对与泪腺腺样囊性癌的发生、侵袭性生长及转移、嗜神经性生长等特性相关的生物学指标的研究也取得了一些进展.就泪腺腺样囊性癌的研究现状做一综述.     

关注泪腺腺样囊性癌诊断和治疗中需要注意的问题

泪腺腺样囊性癌是泪腺最为常见的恶性肿瘤之一,具有较高的复发率和死亡率.此病发病机制不明,预后较差.目前,泪腺腺样囊性癌尚无标准化的诊疗方案,在临床诊疗过程中也存在着一些问题.为了提高有关泪腺腺样囊性癌的诊疗质量,本文将从泪腺腺样囊性癌的流行病学、临床表现、影像学检查方法 的选择、诊断与鉴别诊断、病理组织学改变和免疫组织化学指标、治疗方案的选择及预后等方面加以述评,以期有助于临床医师加强对该病的认识,提高早期诊断率,减少误诊率.     

泪腺腺样囊性癌CT表现的研究

目的 分析泪腺腺样囊性癌常见的CT图像特征,从而探讨CT(computed tomography)影像对于泪腺腺样囊性癌的诊断价值.方法 病历来源为天津医科大学眼科中心及天津医科大学第二医院,经病理确诊的眼眶腺样囊腺癌39例.其中原发肿瘤20例,复发肿瘤19例,均为单眼发病,所有患者均行眼眶CT检查,获取水平及冠状扫描图像.结果 泪腺腺样囊性癌中原发肿瘤形状多为厚扁平状,贴附于眶壁增长,在体层像上呈锥形者10例、不规则形5例;复发肿瘤形状为不规则型8例、厚扁平状,贴附于眶外上壁向后增长者8例.原发与复发泪腺腺样囊腺癌的好发位置位于眶外上方分别为18例与11例.结论 CT可清晰显示肿瘤的位置,形状,范围、眶骨壁改变,对于泪腺腺样囊性癌的诊断和制定治疗方案具有重要指导意义.     

泪腺腺样囊性癌

一、命名、发病率腺样囊性癌系起源于腺体组织,恶性度较高的肿瘤。通常发生在唾液腺、泪腺、也可在气管、乳腺、皮肤汗腺等处发生。眼眶部泪腺腺样囊性癌是泪腺最常见的恶性肿瘤。在泪腺癌中,腺样囊性癌的发病率是25％和35％。本病最初由Billroth在1859年命名为圆柱瘤,他描述此肿瘤原发于鼻窦,以后穿透到     

泪腺腺样囊性癌的分期及临床治疗进展

泪腺腺样囊性癌是泪腺最常见的恶性上皮性肿瘤,手术治疗效果不理想。近年来,随着多种放射治疗和化学治疗的应用,泪腺腺样囊性癌的治疗模式发生较大转变。一方面,临床分期逐步完善,以新的分期为基础的综合治疗得到规范化应用; 另一方面,在质子放疗、中子放疗、经动脉细胞减容化疗等新辅助治疗的支持下,保眼手术逐渐增多,局部复发率和转移率逐渐降低,无病生存期获得延长,但还需要长期观察。本文就近年来国际上泪腺腺样囊性癌相关方面的治疗进展进行综述,以提供新的参考依据。     

爱先蓝和细胞角蛋白双重染色技术在泪腺腺样囊性癌诊断中的应用

目的:探讨爱先蓝(Alcian Blue,AB)和细胞角蛋白(cytokeratin,CK)双重染色技术在泪腺腺样囊性癌组织中的应用,提高泪腺腺样囊性癌染色效率.方法:选取中山大学中山眼科中心临床病理科2015年1月至2017年1月期间诊断为泪腺腺样囊性癌病例标本23例,在同一张切片上先进行AB染色,再进行CK染色,观察染色效果.结果:23例泪腺腺样囊性癌标本组织中黏液物质全部呈蓝色;癌细胞胞质CK阳性,呈棕黄色.结论:AB和CK双重染色方法稳定,颜色对比鲜明,能够良好显示癌细胞及黏液的关系,并且比分开的两次单种染色省时、经济.     

E-cadherin和β-catenin在泪腺多形性腺瘤和腺样囊性癌中的表达

目的研究E-cadherin及β-catenin在泪腺多形性腺瘤和腺样囊性癌中的表达。方法选取经病理检查确诊为泪腺多形性腺瘤的患者11例11眼和腺样囊性癌的患者6例6眼,分别行E-cadherin和β-catenin免疫组织化学染色。选取泪腺脱垂患者的泪腺组织6例作为正常对照组。结果正常泪腺组织中E-cadherin呈强阳性表达,主要位于细胞膜;而在泪腺多形性腺瘤中E-cadherin呈弱阳性表达,主要位于细胞质。E-cadherin在腺样囊性癌中未见表达。3组中E-cadherin阳性表达的样本数差异有统计学意义（H=16.492,P=0.000）;正常泪腺组E-cadherin阳性表达的样本数明显高于多形性腺瘤组和腺样囊性癌组,差异均有统计学意义（U=-3.561,P=0.000;U=-3.108,P=0.002）,多形性腺瘤组中E-cadherin阳性表达的样本数明显高于腺样囊性癌组,差异有统计学意义（U=-2.147,P=0.032）。正常泪腺β-catenin细胞膜呈中度或强阳性表达,多形性腺瘤和腺样囊性癌中β-catenin的表达较正常泪腺组织表达阳性程度差异无统计学意义（P〉0.05）,腺样囊性癌组中β-catenin细胞核阳性的比例（33.3%,2/6）较多形性腺瘤组（72.7%,7/11）低。结论 E-cadherin表达的下降是参与泪腺上皮性肿瘤发生及癌变的重要因素,而E-cadherin的进一步下降甚至缺失,以及β-catenin的核转位可能是参与泪腺多形性腺瘤恶性转化的因素之一。     

10例眼眶腺样囊性癌临床病理分析

１０例眼眶腺样囊性癌临床病理分析北京天坛医院眼科石峙敏，金崇华北京天坛医院病理科俞进腺样囊性癌为一种具有特征性病理形态的恶性肿瘤．发生于泪腺部位较常见．也可发生在眼眶其它部位．本文统计眼眶腺样囊性癌１０例，均经病理确诊，其中９例起源于泪腺，ｌ例源于筛...     

神经细丝酸性蛋白在泪腺腺样囊性癌中的表达及意义

目的研究雪旺细胞标记物神经细丝酸性蛋白（GFAP）在腺样囊性癌有嗜神经性侵袭组与无嗜神经性侵袭组中的表达的差异，旨在进一步探明泪腺腺样囊性癌嗜神经性侵袭性生长的机制。方法应用免疫组化S—P法检测GFAP在28例腺样囊性癌中的表达情况。结果有嗜神经侵袭性生长组中的GFAP阳性表达率较无嗜神经侵袭性生长组呈升高趋势（P〈0．05）。结论泪腺腺样囊性癌的嗜神经性侵袭特性可能与肿瘤细胞中存在着雪旺细胞分化有关。     

泪腺腺样囊性癌一例

泪腺腺样囊性癌一例广东省江门市中心医院眼科严鹏飞病理科陈满根腺样囊性癌系起源于腺体组织、恶性度较高及预后较差的肿瘤，较少见。多发生于大小涎腺，泪腺者罕见。我科于１９９２年５月８日收治了一例，报告如下：患者男，３８岁，因右眼视力下降，眼球向外上活动受限...     

Adenoid cystic carcinoma of the lacrimal gland: report of two cases and literature review

The adenoid cystic carcinoma of the lacrimal gland is a rare malignant orbital tumour, which has a generally poor prognosis. The therapy for adenoid cystic carcinoma of the lacrimal gland remains controversial. We present two cases of patients with adenoid cystic carcinoma of the lacrimal gland, who were treated with radical surgery in combination with radiotherapy. The therapeutic results are discussed with reference to relevant literature reports.     

Adenoid cystic carcinoma of the superonasal conjunctival fornix

The case of a 32-year-old female with a mass in the superonasal conjunctival fornix is described. Histological examination revealed an adenoid cystic carcinoma, which we consider to be most likely derived from an accessory lacrimal gland. The clinical presentation, histological features, management and follow-up are described. A literature review of orbital adenoid cystic carcinoma arising outside the main lacrimal gland is presented.     

Adenoid cystic carcinoma of the superonasal conjunctival fornix

The case of a 32-year-old female with a mass in the superonasal conjunctival fornix is described. Histological examination revealed an adenoid cystic carcinoma, which we consider to be most likely derived from an accessory lacrimal gland. The clinical presentation, histological features, management and follow-up are described. A literature review of orbital adenoid cystic carcinoma arising outside the main lacrimal gland is presented.     

眼眶泪腺癌26例的CT诊断价值

目的：探讨泪腺腺癌的CT诊断价值。 方法：回顾性分析26例26眼经病理证实眼眶泪腺腺癌患者的CT影像资料。 结果：泪腺腺癌26例均为单眼发病,右眼15例,左眼11例。CT表现：病变呈圆形、卵圆形15例,不规则形、分叶形11例。15例边界尚清楚,11例轮廓呈锯齿状。肿瘤密度不均匀,内见低密度灶或钙化。26例病变包绕并压迫眼球,14例沿眶外壁向眶尖区生长,与眼肌分界不清,并浸润视神经。眼眶骨质虫蚀样破坏21例,溶骨性破坏5例。 结论：泪腺癌有特异性CT征象,其诊断准确率高,是本病最主要影像检查方法。     

Primary adenoid cystic carcinoma: an extremely rare eyelid tumor

Cutaneous adenoid cystic carcinoma is an extremely rare clinical entity. Among the few cases reported in the literature, most had contiguous involvement from the lacrimal gland. Primary adenoid cystic carcinoma is one of the rarest eyelid tumors. The authors report a case of adenoid cystic carcinoma arising from the lower eyelid.     

泪腺上皮性肿瘤中CUL-1蛋白和Ki-67蛋白表达的意义

目的 研究 cullin-1（CUL-1）蛋白和Ki-67蛋白在泪腺上皮性肿瘤中的表达及其临床意义.方法 选取手术切取的泪腺上皮性肿瘤31例（多形性腺瘤11例、腺样囊性癌12例和腺癌8例）,其中男19例,女12例,年龄34～68岁,平均（42.5±4.7）岁,单眼发病.另取5例正常泪腺组织作为对照.采用免疫组化SP法检测CUL-1蛋白和Ki-67蛋白在泪腺正常组织及良、恶性上皮性肿瘤中的表达.在200倍视野下,辨别阳性细胞和阴性细胞并计数,计算出CUL-1蛋白和Ki-67蛋白在不同组织的阳性表达率.对各组的阳性表达率作卡方检验.结果 ①CUL-1蛋白的阳性细胞经免疫组化染色后呈棕黄色,分布于细胞核和细胞质,在3种肿瘤中均呈高表达.在多形性腺瘤、腺样囊性癌和腺癌中,CUL-1蛋白的阳性表达率分别为43.10%、46.63%和43.88%;在正常组织呈低表达,阳性表达率为1.43%.经卡方检验,CUL-1蛋白在多形性腺瘤、腺样囊性癌和腺癌组织中的阳性表达率明显高于正常组织（x2=492.821、550.069、504.907,P均＜0.01）,而在良、恶性肿瘤组织中的表达差异则无统计学意义（P＞0.05）.②Ki-67蛋白的阳性细胞经免疫组化染色后呈棕黄色,分布于细胞核.在腺样囊性癌和腺癌中呈高表达,阳性表达率高达48.59%和53.88%;在多形性腺瘤和正常组织中呈低表达,阳性表达率分别为6.06%和4.32%.经卡方检验,Ki-67蛋白在腺样囊性癌和腺癌中的表达明显高于多形性腺瘤（x2=454.522、544.010,P均＜0.01）.结论 CUL-1蛋白在泪腺上皮性肿瘤中表达增高,是导致泪腺上皮细胞异常增生的分子机制之一.Ki-67蛋白在泪腺恶性上皮肿瘤中呈高表达,可作为判断泪腺上皮性肿瘤生物学行为及预后的指标.     

Combined therapeutic approach to malignant lacrimal gland tumors.

The medical records of 13 patients with primary malignant lesions of the lacrimal gland revealed adenoid cystic carcinoma as the most common malignant tumor. The histologic cell type, neural invasion, and bony destruction were correlated with localized control and ultimate survival. Surgical removal of the lacrimal gland was adequate treatment for low-grade mucoepidermoid carcinoma confined to the gland itself. Combining a radical surgical removal of the area in planned sequence with high voltage radiation therapy offered the only reasonable hope for localized control in the more aggressive cell types or in tumors with neural invasion or bony involvement. A 40%-localized control and survival rate was achieved in the adenoid cystic carcinoma group of patients. Radiation therapy administered for cancer that obviously recurs after surgical resection was generally unsuccessful.     

Adenoid cystic carcinoma of the lacrimal sac

Adenoid cystic carcinoma is the most common epithelial malignancy of the lacrimal gland and minor salivary glands. Its occurrence in the lacrimal drainage system is extremely rare. A 57-year-old woman presented with epiphora and a mass in the lacrimal sac, which proved to be an adenoid cystic carcinoma. Histologically, it appeared to arise from the wall of the lacrimal sac, and both the lacrimal gland and maxillary antrum were uninvolved by tumor. Despite aggressive surgical intervention, recurrence and metastasis developed. Adenoid cystic carcinoma must be considered in the differential diagnosis of epiphora.