涎腺肌上皮瘤与多形性腺瘤鉴别诊断的研究

为了探讨涎腺肌上皮瘤与多形性腺瘤的病理鉴别，复查了９３０例多形性腺瘤，对从中确诊的３８例肌上皮瘤进行了病理学和抗ＣＫ－１８、Ａｃｔｉｎ、Ｓ－１００蛋白抗体的免疫组化研究。结果显示：肌上皮瘤的误诊率占多形性腺瘤的４％；病理上分为上皮细胞型、梭形细胞型、浆细胞样细胞型、透明细胞型和混合细胞型，各种形态的瘤细胞可以互相转化；免疫组化显示上述三种抗体各型均呈阳性反应，每例中瘤细胞的阳性程度一致；多形性腺瘤的反应结果则不同。结果表明，明确肌上皮瘤各亚型病理特征是与多形性腺瘤鉴别的关键；免疫组化结果分析有助于两者的鉴别；对组织起源的探讨可从肿瘤分化上认识两者的不同

DIFFERENTIATION STUDY OF MYOEPITHELIOMA AND PLEOMORPHIC ADENOMA OF SALIVARY GLAND

To differentiate myoepithelioma from pleomorphic adenoma of salivary gland, 930 cases of pleomorphic adenoma were reexamined and 38 cases were confirmed to be myoepithelioma. These cases of myoepithelioma were then studied with pathological and immunohistochemistry method in which anticytokeratin 18 (CK 18), Actin, S 100 protein antibodies were used. The results showed that 4% of pleomorphic adenoma should be diagnosed to be myoepithelioma; and that all cases of myoepithelioma could be classified into five types among which transitions of oncocytes existed; CK 18, Actin, S 100 protein antibodies were positively expressed in all these types and positive degree of oncocytes in every type showed no difference while the similar results were not observed in pleomorphic adenoma. This fact suggested that, it was critical differentiating myoepithelima and plemorphic adenoma to grasp the pathological feature of all types of myoepithelioma, analyses of the immunohistochemistry results was useful for the fifferentiation of these two turmors. Studying their histogenesis can help us to know the difference between them from neoplastic differentiation.