口腔颌面部血管瘤和脉管畸形的分类

血管瘤和脉管畸形是口腔颌面部常见病变。随着近年对这类疾病的研究增多和认识的深入，Mulliken等提出脉管病变的生物学分类系统，本文简要介绍该分类，以供临床参考。     

先天性血管瘤及血管畸形的诊断和治疗

1980年以前，我国及许多国家对先天性脉管性疾病的分类和治疗还是非常混乱的，Mulliken和Glowacki 1982年首先进行了生物学分类，经过多年临床实践，1995年Wancr和Suen又修改了此分类，这一新分类已被国际脉管病研究地推荐为国际统一分类， 2004年7月中华口腔医学会口腔颌而外科专业委员会率先在国内成立脉管性疾病学组，     

涎腺良性淋巴上皮病变中上皮岛的免疫组织化学和电镜研究

采用抗肌动蛋白单克隆抗体ＨＨＦ３５和抗细胞角蛋白抗体ＡＥ１／ＡＥ３对１０例涎腺良性淋巴上皮病变（ＢＬＥＬ）中上皮岛的构成细胞进行免疫组织化学研究，同时对３例ＢＬＥＬ进行电镜研究。结果发现：涎腺ＢＬＥＬ中构成上皮岛的细胞大部分呈ＨＨＦ３５阴性，仅在外周可见少许ＨＨＦ３５阳性细胞，而ＡＥ１／ＡＥ３在上皮岛构成细胞中大部分呈阳性。超微结构发现上皮岛大部分由含张力原纤维束的细胞构成，这些细胞结构与残存导管上皮细胞相似，细胞之间散在分布着淋巴细胞和浆细胞。上皮岛外周有时可见含肌微丝的肌上皮样细胞。此结果表明，涎腺ＢＬＥＬ中上皮岛起源于增生的导管上皮，构成细胞主要为导管上皮细胞     

涎腺多形性腺瘤组织起源的免疫组织化学及超微结构研究

选择腮腺、颌下腺多形性腺瘤30例和瘤旁正常涎腺组织13～17例作免疫组化染色,并选其中7例肿瘤组织作电镜观察。结果表明:肿瘤中不同分化的细胞,表达不同的抗原成分;推测该瘤的起源可能与纹管或排泄管处的基底细胞有关。     

抗血管生成类细胞因子对血管瘤内皮细胞生长的影响

血管瘤是婴幼儿最常见的良性肿瘤，其主要特点是毛细血管的内皮细胞增生。到目前为止，其确切的发病机制仍不清楚。血管瘤通常在出生后1个月内出现，之后有7～11个月的增生期，然后是缓慢的消退期。通常在10岁以内，90％的血管瘤可以自然消退。但仍有10％的患儿随着年龄的增长，肿瘤逐渐增大，引起颌面部、肢体的畸形，视力、呼吸等功能障碍。     

婴幼儿血管瘤和血管畸形组织中一氧化氮合酶的表达及意义

目的:研究婴幼儿血管瘤和血管畸形组织中一氧化氮合酶(NOS)的表达差异及其意义。方法:采用免疫组织化学方法及图像分析,检测49例血管瘤和29例血管畸形组织中NOS1、2、3蛋白的表达。分别采用秩和检验的Mann-Whitney test和Kruskal-Wallis test法,比较两组和多组等级变量间的差异;使用标准正态分布统计量Z、X2确定P值,或直接用精确概率法计算P值,P<0.05为有显著性差异。全部资料的统计分析均使用SPSS8.0统汁软件包完成。结果:49例血管瘤组织中,NOS1、2、3蛋白的阳性率为分别为2％、38.8％和38.8％;29例血管畸形组织中,NOS1、2、3蛋白的阳性率分别为0、3.5％和3.5％;血管瘤组织中NOS2、3蛋白的阳性表达率均明显高于血管畸形(P<0.001)。增生期血管瘤组,NOS2、NOS3蛋白的阳性率及消退期血管瘤组NOS3蛋白的阳性率均明显高于血管畸形组(P值分别为0.000、0.000和0.007)。年龄<13个月组和<13-24个月组,血管瘤的NOS2蛋白的阳性表达率均明显高于>24个月组(p分别为0.009和0.003)。结论:血管瘤与血管畸形中NOS蛋白的表达不同,提示两者在病理生理方面存在差异。     

涎腺腺样囊性癌间质成分的电镜组织化学及免疫组…

采用Ⅳ型胶原及纤维连接蛋白的免疫组织化学技术研究２２例涎腺腺样囊性癌，同时采用电镜组织化学技术研究４例筛孔型腺样囊性癌。结果表明，腺样囊性癌筛状结构中分布有复层基板，蛋白多糖和胶原原纤维。免疫组化显示，筛孔中的间质成分富含Ⅳ型胶原和纤维连接蛋白。     

血管瘤与脉管畸形的鉴别诊断研究进展

血管瘤和脉管畸形是婴幼儿比较常见的血管疾病,过去由于对两者的分类和诊断比较混乱,给临床治疗带来诸多不便,也给患者增加了不必要的痛苦。1982年,Mulliken和Glowacki提出了脉管性疾病的生物学新分类,将血管瘤和脉管畸形归类为2种性质完全不同的病变。血管瘤是多发于婴幼儿的良性肿瘤,大多数可以自行消退;而脉管畸形是血管结构的发育异常,不会自行消退,随患者的生长发育持续增长。因此,对于确诊的脉管畸形,应尽早采取干预措施。这就要求临床医师能及时、准确、有效地鉴别诊断血管瘤和脉管畸形。本文就目前关于血管瘤和脉管畸形的鉴别诊断进展作一综述。     

涎腺腺样囊性癌间质成分的电镜组织化学及免疫组织化学研究

采用Ⅳ型胶原及纤维连接蛋白的免疫组织化学技术研究２２例涎腺腺样囊性癌（筛孔型７例,管状型１５例）,同时采用电镜组织化学技术研究４例筛孔型腺样囊性癌。结果表明,腺样囊性癌筛状结构中分布有复层基板、蛋白多糖和胶原原纤维。免疫组化显示,筛孔中的间质成分富含Ⅳ型胶原和纤维连接蛋白。在管状型肿瘤中,小梁和条索周边的间质成分也富含Ⅳ型胶原及纤维连接蛋白。因此提示,Ⅳ型胶原及纤维连接蛋白是腺样囊性癌的主要间质成分,可能由肿瘤性肌上皮细胞分泌产生。     

婴幼儿血管瘤与脉管畸形的循证治疗研究进展

血管瘤及脉管畸形是临床上常见的疾病,根据临床及影像学表现,国际脉管异常研究学会(Interna-tional Society for the Study of Vascular Anomalies,ISSVA)对其进行了详细分类,得到广泛认可和应用.迄今为止,大多数脉管畸形涉及PI3K/Akt/mTOR和RAS/MAP...     

Expression of the endothelial receptor tyrosine kinase Tie2 in lobular capillary hemangioma of the oral mucosa: an immunohistochemical study

BACKGROUND: Lobular capillary hemangioma (LCH) usually occurs in the skin or mucous membranes as a rapidly growing red nodule. LCH is one of the most common vascular lesions in the oral mucosa. Tie2 is a novel, human endothelial receptor tyrosine kinase which may play an important role in blood vessel formation. In this study, we investigated its immunohistochemical expression in LCH of the oral mucosa. METHODS: Double immunostaining with anti-CD34 and antialpha smooth muscle actin (SMA) antibodies was performed to characterize the cellular expression of Tie2 in 15 cases of this condition. RESULTS: We found Tie2 immunoreactivity in the ovoid cells only, which were frequently intermingled with alphaSMA-positive cells, especially in the hypercellular portion of LCH. CONCLUSIONS: These results suggest that the expression of Tie2 in ovoid cells and the interaction between ovoid cells and alphaSMA-positive cells play an important part in the development and progression of LCH.     

紊乱对猴髁突软骨中TGF-β1分布的影响

目的探讨渐进性咬合紊乱所致猴颞下颌关节退形性变中,髁突软骨TGF-β     

Sialadenoma papilliferum: immunohistochemical study

Sialadenoma papilliferum (SP) is a rare benign tumour of salivary gland origin, which has been included among the ductal papillomas in the latest classification of tumours by the World Health Organisation. Two SP from the minor salivary gland of the palate of middle age patients were presented and studied by immunohistochemical. Our results showed presence of cytokeratins (CKs) 13, 14, 7, 8, 19 and absence of vimentin and smooth muscle actin. This immunoprofile is similar to the excretory duct of salivary gland.     

An immunohistochemical study of oral submucous fibrosis

Oral submucous fibrosis (OSF) is a chronic disease of the oral cavity characterized by inflammation and progressive mucosal fibrosis. These reactions may be the result of either direct stimulation from exogenous antigens like areca alkaloids or by changes in tissue antigenicity that may lead to an autoimmune response. This study investigated the presence and distribution of inflammatory cells and MHC class II antigen expression by epithelial and immunocompetent cells using a three-stage immunoperoxidase method on frozen sections. Thirty OSF tissue specimens and ten normal buccal mucosae were studied and compared. All tissues were investigated using antibodies to T cells (CD3), T helper/inducer cells (CD4), T suppressor/cytotoxic cells (CD8), B cells (CD20), naive T cells and monocytes (CD45RA), macrophages. Langerhans' cells (CD68) and HLA-DR-positive cells (HLA-DR alpha). The predominant cell populations detected in normal tissues were CD3, CD4 and HLA-DR-positive cells. The distribution of CD4-positive cells was similar to that of CD3-positive cells, which were scattered, often uniformly distributed, both in the epithelium and connective tissue. CD8-positive cells were occasionally seen in the normal epithelium and lamina propria. Few scattered B cells (CD20) and macrophages (CD681) were observed in normal mucosa. Naive T cells (CD45RA) were seen in all normal tissues focally concentrated around the connective tissue papillae with a similar distribution to that of CD3-positive cells. All normal sections showed HLA-DR-positive cells scattered both in the epithelium and in the lamina propria. Epithelial cells did not show any positive reaction to this antibody and many intraepithelial positive cells showed a dendritic morphology. The cell populations detected in OSF showed higher numbers of CD3 and HLA-DR-positive cells compared with those of the normal tissues. The pattern of staining for CD4-positive cells in OSF tissues was similar to that of CD3-positive cells both in the epithelium and connective tissue and was higher than that in normal tissues. A few scattered CD8-positive cells and only occasional CD20- and CD68-positive cells were seen in OSF sections. Few CD45RA-positive cells were found in the epithelium and lamina propria of OSF sections. However, OSF specimens showed high numbers of HLA-DR-positive cells in the basal layer of the epithelium, juxtaepithelium and in the lamina propria in a similar distribution to that of CD3 cells compared with the normal tissues. Most HLA-DR-positive cells in the epithelium showed dendrites directed vertically towards the surface. The increased evidence of CD4 and HLA-DR-positive cells in OSF tissues suggests that most lymphocytes were activated and shows an increased presence of Langerhans' cells. The presence of these immunocompetent cells and high ratio of CD4 to CD8 in OSF tissues suggest an ongoing cellular immune response leading to a possible imbalance of immunoregulation and alteration in local tissue architecture.     

波形蛋白标记观察人恒前磨牙成牙本质细胞突的分布

目的 :利用免疫酶组化染色技术 ,对人恒前磨牙成牙本质细胞突内的波形蛋白进行定位研究。方法 :将牙齿拔除后立即磨成薄片 ,10 0ml/L中性福尔马林液固定 72h ,10 0ml/L硝酸脱钙。石蜡包埋 ,制取6 μm厚的组织切片。采用SABC法进行免疫组化染色。 结果 :阳性染色的波形蛋白结构在牙本质小管内呈连续较直的长条状。在冠部至釉牙本质界 ,在根部达牙本质小管末端。其分布趋势是从牙本质内层到外层逐渐减少 ,阳性表达程度逐渐减弱。结论 :成牙本质细胞突贯通牙本质全层达牙本质小管末端。     

An immunohistochemical study of oral lichen planus

Specimens from 22 cases of oral lichen planus were prepared for studies of the basement membrane zone by immunohistochemical and histochemical methods. Langerhans' cells, monocytes, and lymphocytes constitute the predominant cells of the inflammatory infiltrate, thus indicating a cell-mediated response. Lymphocyte-related necrosis of epithelium and nonspecific vasculitis are associated with an altered basement membrane zone. Immunoproteins, including IgG, IgA, IgM, and C'3 as well as fibrinogen, are present and distributed in a nonspecific pattern.     

An immunohistochemical study of odontogenic mixed tumours

Five cases of odontogenic mixed tumour comprising of an ameloblastic fibroma, an adenomatoid odontogenic tumour, an odonto-ameloblastoma and two ameloblastic fibro-odontomas were immunohistochemically investigated. Odontogenic epithelial cells were fully positive for cytokeratin detected by antibody KL-1, although there were some differences in its intensity. In contrast, for tenascin, only immature dental papilla-like mesenchymal tissue, especially around the dental lamina-like odontogenic epithelium, was positive, while the myxomatous area and connective tissue were negative. Positive vimentin staining was observed in some areas of immature dental papilla-like cells as well as the basement membrane of odontogenic epithelium in the ameloblastic fibroma, suggesting that this tumour had developed at the early stage of tooth formation. Proliferating nuclear cell antigen-positive cells were generally rarely seen, but were frequently observed in epithelial cells of the ameloblastic fibroma and odonto-ameloblastoma. These observations suggest that tumour cells in each odontogenic mixed tumour possess characteristic proteins associated with proliferation potential and that ameloblastic fibroma and odonto-ameloblastoma have higher proliferation potential among the tumours examined.     

A immunohistochemical study of the peripheral ameloblastoma

AIM: Peripheral ameloblastoma (PA) is a rare variant of ameloblastoma occurring in the extraosseous region. With regard to the histogenesis of the tumor, two major sources of origin are considered: odontogenic epithelial remnants and the gingival epithelium. In this study, we examined the immunohistochemical profiles of cytokeratins (CKs) and Ki-67 labeling index (LI) of PAs, and discuss the histogenesis and the biologic behavior of the PA. MATERIALS AND METHODS: Eight cases of PA were retrieved from the pathology files of 212 cases of ameloblastoma that had been registered at our hospital. Immunohistochemical staining was performed in seven cases using monoclonal antibodies of six CKs (7, 8, 13, 14, 18, and 19) and Ki-67. RESULTS: All cases of PA expressed CK13, 14, and 19. CK18 was positive staining in six cases, and CK8 in five cases. This staining pattern was similar to that in intraosseous ameloblastomas (IAs). The mean of Ki-67 LI of PAs (1.91%) was significantly lower than that of IAs (4.82%) (P = 0.002). CONCLUSION: We consider that the PA originates from odontogenic epithelial remnants rather than from the gingival epithelium, and the Ki-67 LI of the tumor is a good prognostic indicator.