A rare case of sclerosing mucoepidermoid carcinoma arising in minor salivary glands with immunohistochemical evaluation

Mucoepidermoid carcinomas (MECs) are the most common malignancy of the salivary glands demonstrating a wide range of histologic variants and behavior. However, the sclerosing mucoepidermoid carcinoma (SMEC), a morphologic variant of this tumor is extremely rare and has been described almost exclusively in the major glands. The prominent sclerosis observed may obscure its typical morphological feature resulting in a diagnostic challenge. We describe herein a case of SMEC in a 43-year-old-woman, occurring in the minor salivary glands of palate. To our knowledge only 13 cases have been reported until this moment, being only 2 in minor salivary glands. We also performed the immunohistochemical evaluation of c-erbB-2 and Ki-67, searching for an association with the histopathological findings and behavior.     

涎腺黏液表皮样癌银染核仁组成区图像定量分析

目的 通过对癌细胞核仁组成区(NOR)的图像定量分析,评价不同分化程度的涎腺黏液表皮样癌的细胞增殖能力。方法 对30例涎腺黏液表皮样癌进行银染核仁组成区(AgNORs)染色,应用图像分析技术观察测定癌细胞核内AgNORs颗粒的各种形态参数,并作比较分析。结果 不同分化程度的病变中,AgNORs颗粒均数、平均面积、形态及分布都有一定的差异。随肿瘤分化程度的降低,AgNORs均数及面积逐级增多。结论 涎腺黏液表皮样癌细胞增殖能力与其分化程度密切相关,AgNORs图像定量分析对其分级诊断有参考价值。     

Acinic cell carcinoma of minor salivary gland origin

We describe a case of acinic cell carcinoma of the right soft palate in a 65-year-old man. The primary symptom was a painless swelling of the palate, which was partially ulcerated with a granulomatous appearance. Ultrastructurally, the tumor cells were mainly composed of differentiated acinuslike cells containing numerous round secretory granules identical to those in normal serous salivary glands. The tumor cells frequently contained numerous long crystalloid structures in the cytoplasm. Furthermore, tumor cells demonstrating degrees of squamous differentiation were present. These cells contained intracytoplasmic keratin filaments and a few keratohyaline granules. They formed a glandular acinar space in direct contact with the typical acinic cells with secretory granules. These observations suggest that acinic tumor cells have a degree of multipotentiality.     

Establishment of a human cancer cell line from adenoid cystic carcinoma of the minor salivary gland

This paper reports the establishment of a human cancer cell line from adenoid cystic carcinoma of the minor salivary gland and the study of its biological behaviours. The cells of the cell line (SACC-83) are polygonal in shape, with a mosaic arrangement. Ultrastructural study reveals that many secretory granules are present in the cytoplasm. The mitosis index, growth curve, chromosome analysis and transplantation into nude mice were performed and discussed. The results prove that this cell line possesses the morphological and biological features of adenoid cystic carcinoma.     

Kuttner tumour: an unusual cause of enlargement of a minor salivary gland in the lip

Kuttner tumour is benign, chronic, sclerosing sialadenitis that usually occurs in the submandibular gland and is regarded as a salivary gland neoplasm because of its clinical features. We describe a tumour arising from a minor salivary gland of the upper lip. To our knowledge, there are only two previously reported cases.     

Acinic cell carcinoma arising in the glossopalatine glands: a report of two cases with electron microscopic observations

Two cases of acinic cell carcinoma arising in the glossopalatine glands were examined with the electron microscope by means of conventional thin sectioning and freeze-fracturing. Light and electron microscopic observation revealed that the tumors consisted of three types of cells: serous-type, ductlike, and vacuolated cells. Serous-type cells had numerous secretory granules, some of which were discharged into the intercellular spaces. Ductlike cells were smaller, usually lacked secretory granules, and were similar to intercalated duct cells. Vacuolated cells had electron-opaque vacuoles in the cytoplasm. Our findings supported the hypothesis that acinic cell carcinoma may represent a neoplasm of multipotential duct cells which have differentiated mainly into granulated serous cells. Freeze-fracture images of this tumor revealed that tight junctions were composed of ten or more interlinked strands with elongation of basal frontier strands. These findings suggested that the junctional morphology of the tumor resembled that of developing salivary glands and was associated with the degree of cellular differentiation.     

Lipofuscin in salivary glands in health and disease.

Lipofuscin granules were observed in normal salivary glands (parotid, submandibular, and minor salivary glands). The pigment was confined mainly to the epithelial cells of the intralobular ducts, but isolated granules were also found in acinar cells and myoepithelial cells. In chronic sialadenitis pigment granules were found in the intralobular epithelial cells and in macrophages in the surrounding ionnective tissue. In benign epithelial tumors pigment granules were observed within neoplastic epithelial cells and in macrophages in the stroma, while malignant tumors displayed pigmented granules only in macrophages in the stroma.     

Epithelial-myoepithelial carcinoma of salivary glands

Four cases of epithelial-myoepithelial carcinoma of salivary gland origin are presented and discussed. The mean age of these four patients was 68 years, with an age range of 51 to 78 years. Three of the patients were women, and one was a man. This article emphasizes the light microscopic, histochemical, and ultrastructural features of the neoplasm. Electron microscopic examination of glutaraldehyde-fixed fresh tissue and previously formalin-fixed tissue reveals that the characteristic clear cytoplasm of abluminal cells is caused, in part, by glycogen storage granules and the paucity of organelles but largely by an artifact of fixation.     

Parotid secretory granules: crossroads of secretory pathways and protein storage

Saliva plays an important role in digestion, host defense, and lubrication. The parotid gland contributes a variety of secretory proteins-including amylase, proline-rich proteins, and parotid secretory protein (PSP)-to these functions. The regulated secretion of salivary proteins ensures the availability of the correct mix of salivary proteins when needed. In addition, the major salivary glands are targets for gene therapy protocols aimed at targeting therapeutic proteins either to the oral cavity or to circulation. To be successful, such protocols must be based on a solid understanding of protein trafficking in salivary gland cells. In this paper, model systems available to study the secretion of salivary proteins are reviewed. Parotid secretory proteins are stored in large dense-core secretory granules that undergo stimulated secretion in response to extracellular stimulation. Secretory proteins that are not stored in large secretory granules are secreted by either the minor regulated secretory pathway, constitutive secretory pathways (apical or basolateral), or the constitutive-like secretory pathway. It is proposed that the maturing secretory granules act as a distribution center for secretory proteins in salivary acinar cells. Protein distribution or sorting is thought to involve their selective retention during secretory granule maturation. Unlike regulated secretory proteins in other cell types, salivary proteins do not exhibit calcium-induced aggregation. Instead, sulfated proteoglycans play a role in the storage of secretory proteins in parotid acinar cells. This work suggests that unique sorting and retention mechanisms are responsible for the distribution of secretory proteins to different secretory pathways from the maturing secretory granules in parotid acinar cells.     

抑癌基因PTEN在涎腺癌组织中的表达

目的:研究PTEN在正常涎腺组织及涎腺癌中的表达及意义。方法:应用免疫组化S鄄P法分别检测8例正常涎腺组织,24例粘液表皮样癌,26例腺样囊性癌中PTEN蛋白的表达。结果:PTEN蛋白在正常涎腺组织及涎腺癌中表达率分别为87.5%、22%,差异有显著性意义(P﹤0.05)。PTEN在高、中分化组粘液表皮样癌高表达率为35.3%,低分化组为28.5%,差异无显著性意义(P>0.05)。腺样囊性癌中PTEN蛋白表达率低于粘液表皮样癌,差异有显著性意义(P﹤0.05)。结论:提示PTEN蛋白与涎腺癌的发生、发展密切相关,PTEN蛋白表达与涎腺癌组织类型有相关性,而与组织学分级无明显相关性。     

β-连环蛋白在涎腺恶性肿瘤中表达的意义

目的研究涎腺恶性肿瘤中的β-连环蛋白在涎腺恶性肿瘤中的表达以及表达水平,探讨连环蛋白与涎腺恶性肿瘤分化、浸润、侵袭、转移之间的关系。方法采用Envision免疫组织化法检测颌面部涎腺多形性腺瘤标本21例,涎腺恶性肿瘤标本52例石蜡标本β-连环蛋白的表达水平。结果β-连环蛋白在涎腺炎症组织中有正常表达,而在涎腺恶性肿瘤中则是表达显著下调,甚至失表达。β-连环蛋白的表达在恶性涎腺肿瘤标本中与肿瘤分化程度相关,β-连环蛋白的表达在低分化组与高、中分化组之间有显著性差异(P<0.05)。β-连环蛋白的失表达主要发生于有淋巴结转移的涎腺恶性肿瘤。结论β-连环蛋白在涎腺炎症上皮组织中有稳定而强烈的表达,而在涎腺恶性肿瘤存在异常表达或失表达。可能与涎腺恶性肿瘤的病理分级有关。β-连环蛋白的存在与否可能决定肿瘤的侵袭、神经、血管侵犯及淋巴结转移。同时Envision免疫组化法可以作为研究涎腺肿瘤的一种重要的实验方法。     

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。     

PTTG和bFGF在唾液腺癌组织中的表达及意义

目的探讨PTTGmRNA及其蛋白和bFGF蛋白的表达与唾液腺癌生物学行为及预后的关系。方法应用免疫组化-SP法检测30例唾液腺癌及癌旁组织中PTTG、bFGF蛋白的表达;半定量逆转录聚合酶链反应（RT-PCR）法分析30例唾液腺癌及癌旁组织中PTTGmRNA的表达。结果①PTTG蛋白平均灰度值在唾液腺癌组织和癌旁组织中分别为0.597±0.487和0.436±0.173,癌旁组织中的表达量高于癌组织（P〈0.05）;bFGF蛋白平均灰度值在唾液腺癌组织和癌旁组织中分别为0.533±0.286和0.738±0.763,癌组织中的表达量高于癌旁组织（P〈0.05）。②相关性研究显示,在唾液腺癌组织中PTTG蛋白和bFGF蛋白关系密切,相关系数为0.659,具有统计学意义（P〈0.05）。③PTTGmRNA在唾液腺癌及癌旁组织中均有表达,且癌旁组织高于癌组织,二者有显著性差异（P〈0.05）。④在唾液腺癌组织中,PTTGmRNA及其蛋白和bFGF蛋白表达量均与有无淋巴结转移和临床分期有关,而与年龄、性别无关。结论①PTTG作为一个新型的原癌基因,其过度表达可能参与了唾液腺癌组织的发生、发展过程。②bFGF在唾液腺癌组织中高表达,可以用于判断肿瘤的恶性程度。③在唾液腺癌组织中PTTG蛋白和bFGF蛋白关系密切,可能在肿瘤的发生、发展中起协同作用。     

涎腺肿瘤C-erbB-2癌基因mRNA表达的研究

目的 探讨Ｃ－ｅｒｂＢ２－ｍＲＮＡ表达水平同涎腺肿瘤组织类型、发生和生物学性质的关系。方法 采用ｄｏｔ ｂｌｏｔ杂交,以＾３２Ｐ标记的寡核苷酸探针,以正常涎腺为对照,对涎腺肿瘤Ｃ－ｅｒｂＢ－２ｍＲＮＡ表达进行研究。结果 正常涎腺和涎腺肿瘤中惺峭同程度Ｃ－ｅｒｂＢ－２ｍＲＮＡ的表达,以正常涎腺组织的表达水平为基准,在腺淋巴瘤、基底细胞腺瘤呈现低表达、无表达或正常涎腺组织表达水平相似,多形性腺瘤、粘液     

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目的 研究垂体瘤转化基因(PTTG)的表达与唾液腺腺样囊性癌(SACC)临床病理特点之间的关系.方法 应用免疫组织化学SP法检测40例SACC组织及20例癌旁非癌组织中PTTG的表达.采用SPSS11.5统计软件包,应用x2检验对结果数据进行统计学处理.结果 SACC组织中PTTG的表达明显升高,与非癌组织之间的差异具有统计学意义(P＜0.05).PTTG的表达与SACC的病理类型无关(P＞0.05).结论 PTTG在SACC组织中呈高表达.PTTG的表达与SACC的发生密切相关,PTTG的异常激活是SACC恶性增殖的原因之一.     

M期促进因子在唾液腺腺样囊性癌中的表达

目的：研究M期促进因子（MPF）的表达与唾液腺腺样囊性癌（SACC）临床病理特点之间的关系。方法：应用免疫组织化学SP法检测40例SACC组织及40例正常唾液腺组织中MPF的表达。应用Westem印迹测定SACC细胞系SACC-83和SACC肺高转移细胞系SACC-LM中MPF的表达。采用SPSS11．5统计软件包,分别应用χ^2检验、配对t检验和线性相关分析进行统计学处理。结果：SACC组织中MPF的表达明显升高,与正常唾液腺组织之间存在显著差异（P〈0．05）。MPF的表达与SACC的病理类型有关（P〈0．05）。体外培养的SACC细胞系SACC-LM中MPF的表达显著高于SACC-83中MPF的表达（P〈0．05）。结论：MPF在SACC组织中呈高表达,其表达与SACC的发生密切相关,MPF的异常激活是SACC恶性增殖的原因之一,MPF与SACC的转移能力有关。     

Clear cell carcinoma of the mandibular gingiva 'minor salivary gland': a case report with immunohistochemical study

Clear cell carcinoma is a rare neoplasm that arises in salivary glands. They are more frequent in the intraoral minor salivary glands than the major salivary glands. The present case involved a 44-year-old Japanese man with a slight reddish swelling on the mandibular gingiva. Initial clinical diagnosis was squamous cell carcinoma based on this erythroplakial lesion. All tumor cells displayed the expected pattern of immunoreactivity, with positive results for pancytokeratin and high molecular weight cytokeratin. This report examined the immunohistochemical characteristics of clear cell carcinoma, minor salivary gland, and reviewed the existing literature.     

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目的探讨肌动蛋白聚合蛋白-1(Fascin-1)在人涎腺腺样囊性癌(SACC)中的表达及临床意义。方法选择2007年11月至2009年12月哈尔滨医科大学附属口腔医院口腔颌面外科手术切除涎腺组织的患者63例,其中SACC患者46例,涎腺正常患者17例。应用免疫组化法检测SACC和正常涎腺组织中Fascin-1的表达水平,比较并分析其与患者其他因素的相关性。结果 Fascin-1在SACC组织中的表达率明显高于正常涎腺组织(P<0.01)。Fascin-1在SACC组织中的表达,与患者的年龄、性别、部位、肿瘤大小和病理类型无关(P>0.05)。临床分期Ⅲ～Ⅳ期的癌组织Fascin-1表达阳性率明显高于Ⅰ～Ⅱ期(P<0.05),有区域淋巴结转移患者Fascin-1表达阳性率明显高于无区域淋巴结转移者(P<0.05)。结论 Fascin-1表达与SACC患者的临床分期和淋巴结转移相关。     

Dnmt1和Dnmt3b在唾液腺黏液表皮样癌中的表达及意义

目的： 探讨DNA 甲基转移酶（DNA methyltransferase, Dnmt）在唾液腺黏液表皮样癌（mucoepidermoid carcinoma,MEC）中的表达及意义。方法： 选取2010 年1 月—2013 年9 月间中国医科大学附属盛京医院口腔颌面外科手术切除的唾液腺术后的标本43例,正常唾液腺组织17例,应用免疫组织化学和蛋白免疫印迹（Western blot）方法检测正常组织及MEC组织中Dnmt1和Dnmt3b 的表达。采用SPSS22.0软件包对数据进行统计学分析。结果： Dnmt1在MEC组织中的阳性表达率为37.21%,与正常唾液腺组织的17.65%相比,差异无显著性（P>0.05）;Dnmt3b在MEC组织中的阳性表达率为83.72%,显著高于正常唾液腺组织的11.76%（P<0.01）;但两者的高表达与临床病理参数之间无显著相关性（P>0.05）。结论： Dnmt3b在唾液腺MEC 的发生中可能发挥一定作用。     

The screening and electron microscopy observation of mammary analogue secretory carcinoma in Chinese

Mammary analogue secretory carcinoma of salivary gland (MASC) is a tumor with histopathologic and immunophenotypic features mimicking secretory carcinoma of the breast harboring the ETV6 split. The expression of mammaglobin, S-100, Ki-67, P63 and ETV6 split were detected in twelve cases of acinar cell carcinoma and fourteen cases of mammary analogue secretory carcinoma of salivary gland by immunohistochemistry and fluorescence in situ hybridization respectively. The expression of ETV6 gene split was detected in fourteen mammary analogue secretory carcinomas of salivary gland with positive expression of mammaglobin. Eight of mammary analogue secretory carcinomas of salivary gland also tested positive for the ETV6 gene split via fluorescence in-situ hybridization (FISH). The concordance rate of the immunohistochemistry and FISH was 72.3%. Mammaglobin and ETV6 gene split detection could help to distinguish mammary analogue secretory carcinoma of salivary gland. The mammary analogue secretory carcinoma of salivary gland specimens were also examined under transmission electron microscope. And apical junctional complexes were observed in the loosely connected tumor cells.