205例老年人涎腺肿瘤临床病理分析

２０５例老年人涎腺肿瘤临床病理分析南京医科大学口腔病理教研室（２１００２９）宋晓陵南京市口腔医院病理科陈君勤口腔颌面部肿瘤对老年人健康危害极大。在老年人口腔肿瘤中，涎腺上皮来源的良恶性肿瘤占有相当大的比例，为探索其临床病理特点，现将我们在过去１０年中...     

500例老年人涎腺肿瘤的临床分析

老年人口腔颌面部肿瘤中涎腺肿瘤占很大比例,在老年人群中的发病特点及各类涎腺肿瘤在大、小涎腺中的分布却少见报道.本文收集我科近十年来老年涎腺肿瘤住院患者500例临床资料,针对发病年龄、性别、部位及不同病种与良、恶性肿瘤间的构成比进行分析,旨在提示目前老年人涎腺肿瘤的现状,为老年人常见涎腺肿瘤的治疗提供依据.     

涎腺肿瘤的基因治疗

涎腺肿瘤 （salivary gland tumors） 是口腔颌面部常见的一类肿瘤.该肿瘤发病率较高,且形态结构复杂,变化较大.对于该肿瘤的治疗,目前仍以手术治疗为主.除良性肿瘤及部分低度恶性肿瘤手术治疗效果较好外,大多数涎腺恶性肿瘤缺乏特异性治疗手段,术后常常出现复发.近年来,基因治疗的应用研究逐渐成为涎腺肿瘤,特别是涎腺恶性肿瘤的研究热点.并已逐渐作为手术、化疗、放疗等常规疗法的一个重要补充.本文收集整理了国内外近期研究文献,就涎腺肿瘤基因治疗的基本方法及存在问题进行综述.     

涎腺肿瘤的手术治疗

涎腺亦称唾液腺，由三对大的唾液腺(腮腺、颌下腺、舌下腺)和遍布于上消化道及气管黏膜、口腔黏膜下的小唾液腺所组成。腮腺肿瘤发生率最高约占80％，颌下腺肿瘤占10％，舌下腺肿瘤占1％，小涎腺肿瘤占9％。涎腺肿瘤95％以上发生于腺上皮，如多形性腺瘤、腺淋巴瘤、腺样囊性癌、黏液表皮样癌等；来源于间叶组织的肿瘤仅占5％以下，如脂肪瘤、纤维瘤、血管瘤、淋巴管瘤等。口腔颌面部的涎腺组织所处的部位     

13例涎腺粘液表皮样癌的临床术前误诊分析

总结１３例老年人涎腺粘液表皮样癌的临床治疗,分析其误诊原因,方法对病例的临床表现,肿瘤好发部位,手术治疗及病理分型情况进行回顾性分析。结果术前误诊为混合瘤首次单纯局部切除手术９例,而行再次根治术。结论ＭＥＧ与涎腺混合瘤极其相似,术前误诊率高,应引起临床医师的高度重视 。     

涎腺腺样囊性癌p16-pRB-cyclinD1通路的研究

涎腺腺样囊性癌(ACC)是涎腺恶性肿瘤中最常见恶性肿瘤之一,严重危害人的生命,多发于中老年患者。对头颈部肿瘤p16蛋白、视网膜母细胞瘤蛋白(pRB)、细胞周期蛋白D1(cyclinD1)(p16-pRB-cyclinD1通路,RB通路)的研究主要集中在口腔鳞形细胞癌(SCC)上,其作用和意义已被证实[1]。但对     

下颌磨牙后区小涎腺杂交瘤1例报告

涎腺杂交瘤是一种罕见的肿瘤,未纳入新版WHO(2005年)涎腺肿瘤组织学分类,但国外文献作为一种肿瘤己有报道和描述[1]。本文通过1例发生于下颌磨牙后区小涎腺杂交瘤临床病理分析及文献回顾探讨其病理学特征及肿瘤组织细胞起源。1临床资料1.1病例患者男,60岁,左下磨牙区牙龈肿物伴     

涎腺原发性鳞状细胞癌1例临床病理分析

涎腺原发性鳞状细胞癌,是临床和病理检查中较罕见的一种恶性肿瘤.现报道1例该病患者,并结合文献复习,对其临床特征、病理学特征进行分析,对鉴别诊断进一步掌握,以加深对此病的认识与认知,并在临床治疗上选用最妥贴的方法治疗患者.     

涎腺腺样囊性癌组织中survivin、COX-2的表达变化及意义

目的观察涎腺腺样囊性癌（SACC）组织中survivin、环氧化酶-2（COX-2）的表达变化，并探讨其临床意义。方法采用免疫组化法检测42例SACC及22例正常涎腺组织中的survivin、COX．2蛋白。结果SACC组织中survivin、COX-2蛋白阳性率分别为59．5％（25／42）、64．3％（27／42），正常涎腺组织中分别为0、4．5％；两者比较，P均〈0．05。SACC组织TNM分期Ⅲ～Ⅳ期survivin、COX-2蛋白阳性率分别为84．6％（11／13）、84．6％（11／13），显著高于Ⅰ～Ⅱ期的48．2％（14／29）、55．1％（16／29），P均〈0．05。相关分析显示，SACC组织中survivin、COX-2蛋白表达呈正相关（r=0．832，P〈0．05）。结论SACC组织中COX-2、survivin高表达，二者在SACC发生、发展中发挥重要作用。     

Tamoxifen for salivary gland adenoid cystic carcinoma: report of two cases

PURPOSE: Adenoid cystic carcinoma of the salivary gland (ACC-SG) is a slow-growing tumor that is refractory to most chemotherapeutic agents. Estrogen receptor (ER) antagonists provide a novel approach for recurrent disease. METHODS: We report two cases of ACC-SC in which Tamoxifen/Toremifene were used. RESULTS: Both patients obtained long-term stability of disease with no associated toxicity. CONCLUSIONS: Given the relatively unsuccessful treatments for ACC-SC and the low toxicity of ER antagonists, such therapy should be considered in these patients for its potential disease-stabilizing effects.     

唾液腺提取物抗衰老作用初步研究

目的：研究唾液腺提取物（SGE）的抗衰老作用。方法：以400mg/kg和1500mg/kg剂量的SGE分别饲喂SD大鼠75d，以400mg/kg剂量的SGE饲喂HIN小鼠45d，采用NBT光化还原法和TBA荧光法分别测定其红细胞SOD活性及血清LPO含量，同时测定胸腺和脾指数。结果：SGE均能显著提高大、小鼠血细胞SOD活性和大鼠SOD比活性，显著降低大、小鼠血清LPO含量，提高大鼠胸腺指数，结论：SGE能显著提高动物红细胞SOD活性，降低血清LPO含量，提高胸腺指数，具有明显的抗衰老作用。     

流式细胞学DNA分析在良、恶性涎腺多形性腺瘤中的应用价值

目的　探讨流式细胞学 DNA分析 (FCM)对良、恶性涎腺多形性腺瘤的临床价值。方法　采用流式细胞仪测定 5 0例良性涎腺多形性腺瘤、18例恶性涎腺多形性腺瘤和 10例正常涎腺石蜡包埋组织的 DNA倍体及细胞增殖活性 ,分析其变化与预后的关系。结果　正常涎腺组织 DNA皆为二倍体 ;良性涎腺多形性腺瘤 DNA二倍体率为 84 % (42例 ) ,异倍体率 16 % (8例 ) ;恶性涎腺多形性腺瘤分别为 6 1% (11例 )、39% (7例 ) ,与良性者比较有显著性差异 (P<0 .0 5 )。结论　 FCM诊断良、恶性涎腺多形性腺瘤具有一定价值 ,其应用应与形态学检查相结合。     

Evaluation of submandibular versus labial salivary gland fibrosis in IgG4-related disease

Abstract

The newly comprehensive diagnostic criteria in 2011 emphasize the importance of IgG4-positive plasmacyte infiltration along with storiform or swirling fibrosis and obliterative phlebitis in diagnosing IgG4-related disease(RD). Although labial salivary gland (LSG) biopsy is a minimally invasive and convenient procedure for obtaining tissues, LSG fibrosis is thought to be inconspicuous or absent in IgG4-RD cases. In this study we evaluated 15 patients with IgG4-RD, in whom both submandibular gland (SMG) and LSG biopsies were performed at the same time. Histological evaluation revealed fibrosis in all the SMG specimens but in only one LSG specimen (6.7%). The diagnosis of IgG4-RD is primarily based on its morphological appearance on biopsy. The results of this study demonstrated that although more invasive than LSG biopsy, SMG biopsy is recommended for accurate diagnosis of IgG4-related MD and to exclude malignant diseases.     

Oral-pharyngeal dysphagia: A common sequela of salivary gland dysfunction

Saliva plays a critical role in alimentary events, allowing food to be initially processed, formed into a bolus, and subsequently transported through the oral cavity. Patients with salivary gland hypofunction often present with dysphagic complaints. We therefore evaluated the possible relationship between salivary performance and swallowing ability in such patients. Patients subjectively reporting difficulty in swallowing had significantly lower salivary flow rates (1/6–1/3 less) than persons without such complaints. Similarly, patients with documented salivary hypofunction displayed significantly increased duration (more than two-fold) of the oral phase of swallowing for several experimental swallowing conditions. Our results support the hypothesis that dysphagia can result from conditions leading to salivary gland hypofunction.     

COX-2及survivin在涎腺多形性腺瘤中表达的定量研究

目的　探讨环氧合酶- 2 (COX- 2 )及生存素(survivin)在良、恶性涎腺多形性腺瘤中的表达及其与肿瘤发生发展的关系。方法　采用流式细胞技术检测5 0例良性、17例恶性涎腺多形性腺瘤组织中COX- 2与survivin的表达,并与10例正常腮腺组织进行对比分析。结果　良、恶性涎腺多形性腺瘤及正常腮腺组织COX- 2的阳性表达率分别为76 %、10 0 %、0 ,其荧光指数(FI)分别为1.79±0 .12、3.0 1±0 .4 0、0 .82±0 .0 5。survivin阳性表达率分别为5 6 %、10 0 %、0 ,FI分别为1.0 6±0 .5 9、1.85±0 .16、0 .5 6±0 .0 8。各组间COX- 2与survivin表达量有明显差异(P均<0 .0 1)。在17例恶性涎腺多形性腺瘤中COX- 2与survivin的协同表达率为10 0 %。结论　COX- 2与survivin基因与涎腺多形性腺瘤的发生及恶变关系密切。     

Hepatitis C virus infection of salivary gland epithelial cells: Lack of evidence

Background: Hepatitis C virus genome (HCV-RNA) has been detected in whole salivary gland tissue of chronically infected patients. However, contamination of the tissue by plasma or blood cells was not excluded by the previous reports.Aims: To assess whether HCV infects the salivary gland epithelial cells in patients with chronic HCV liver disease.Methods: Twenty unselected patients with chronic active hepatitis (11 cases) or active cirrhosis (nine cases) were examined. Serum and saliva samples were obtained from all patients, 12 of whom (seven, chronic active hepatitis; five, active cirrhosis) underwent salivary gland biopsy. PCR for HCV-RNA was performed on RNA extracted from serum, saliva and salivary gland epithelial cells collected by isokinetic gradient separation after trypsin digestion of whole salivary gland tissue. Saliva samples were also examined for the presence of secretory IgA anti-HCV by gel chromatography and ELISA testing.Results: HCV-RNA was detected in all sera with titers ranging from 5.42×10⁵ genome equivalents/ml to 123.2×10⁵ genome equivalents/ml. Thirteen patients were infected with genotype 1b, four patients had genotype 1a, two patients had genotype 2a and one patient was unclassifiable. Low titer HCV-RNA (<2×10⁵ genome equivalents/ml) was detected in saliva samples (15%) from highly viremic patients infected with 1b genotype. RNA extracted from salivary gland epithelial cells consistently tested negative for HCV-RNA. In addition, all saliva specimens tested negative for secretory-IgA (S-IgA) anti-HCV, even after a 10-fold concentration of the samples.Conclusions: There was no evidence that HCV infects the salivary gland epithelial cells in our viremic patients with HCV chronic liver disease. Low level HCV-RNA in saliva is most probably due to virus spillover from blood.     

Molecular and phylogenetic analysis of a novel salivary defensin cDNA from malaria vector Anopheles stephensi

Manipulating the endogenous immune responses of the mosquito such as temporal and spatial expression of antimicrobial peptides may help in the development of a refractory mosquito, unable to transmit malaria. In mosquito several small antimicrobial peptides are activated locally in the midgut and salivary glands upon Plasmodium infection. Anopheles stephensi, the major urban malaria vector in India, has been considered as an important insect model to study vector-parasite interactions; however, so far no reports are available on the antimicrobial peptides from this mosquito species. In the present study, we report identification and molecular characterization of a novel cDNA encoding defensin like peptide, isolated from the salivary gland subtractive hybridization cDNA library of mosquito A. stephensi. Defensin cDNA is 396 base pair long, bearing an open reading frame of 96 amino acids. Deduced amino acid sequence of A. stephensi defensin (Astp_def) contains a signal peptide sequence of 24 amino acids followed by 32-amino acids long putative propeptide domain and a 40-amino acid mature peptide domain carrying 23-amino acid long consensuses sequence signature of insect defensin. Mature peptide of Astp_def carries six conserved cysteine residues, with a predicted molecular weight of 4.20kDa, and isoelectric point of 8.30, characteristic features of cationic defensins. Amino acid sequence similarity and phylogenetic analysis indicated a higher variation in the pre-propeptide region, as compared to the mature defensin peptide, assuring the presence of finely tuned immune responses to counter pathogens.