涎腺肌上皮瘤的临床病理分型和免疫组化研究

对从１８７３例涎腺肿瘤复查后确诊的４３例涎腺肌上皮瘤进行了临床病理学和免疫组化研究。结果显示：该瘤的患病率约占涎腺肿瘤的２．３％，好发于腮腺（４８．８４％）和腭腺（４１．８６％）；该瘤在病理上可分为５型：即上皮细胞型、梭形细胞型、浆细胞样细胞型、透明细胞型和混合细胞型，其实质细胞——肿瘤性肌上皮细胞为一个连续变化的瘤细胞谱，各种形态的瘤细胞可以互相转化；免疫组化ＣＫ－１８、ａｃｔｉｎ染色显示上述各型瘤细胞均为程度不等的阳性。作者认为提高该瘤确诊率的关键是对各型瘤细胞的认识；联合应用ＣＫ－１８、ａｃｔｉｎ有助于该瘤的诊断和与多形性腺瘤的鉴别。

Clinicopathological classification and immunohistochemical study on myoepithelioma of salivary gland

43 cases of myoepithelioma of salivary gland,confirmed by histological examination from 1873 cases of salivary gland tumors,were studied clinicopathologicaly and immunohistochemicaly.The results showed that the morbidity of myoepithelioma constituted 2.3% of the salivary gland tumor. The tumor was most frequently found in parotid gland (48.84%) and palatine glands (41.86%).It could be classified into five types on the basis of histopathology:Epithelial , Spindle , Plasmacytoid ,clear and Mixed cell types. The parenchymal cells,neoplastic myoepithelial cells are a continuous oncocyte pedigree and the five kinds of cells might change their phenotypes from one to the other or others. Immunohistochemical staining indicated various degree of CK 18 and actin expression in the five types of the tumor cells. It is important to recognize the various oncocytes for diagnosis. Use of CK 18 and actin antibodies is an authentic method to improve confirmed diagnosis rate of the tumor.