涎腺肿瘤组织TN－CmRNA和CDgmRNA的表达及其意义

目的：探讨Tenascin-C（TN－C）mRNA和CD9mRNA在涎腺肿瘤的表达及其对涎腺肿瘤鉴别诊断的价值。方法：采用原位杂交技术检测10例正常涎腺组织、25例多形性腺瘤（PA）、25例腺样囊性癌（ACC）、20例黏液表皮样癌（MEC）、10例腺泡细胞癌（ACCa）中TN-CmRNA和CD9mRNA的表达。结果：TN-CmRNA在正常涎腺组织中呈阴性表达;CD9mRNA在正常涎腺组织中的阳性率为100％;TN-CmRNA、CD9mRNA在4种涎腺肿瘤中均有表达,TN-CmRNA在多形性腺瘤中的阳性表达率显著高于腺样囊性癌和黏液表皮样癌,差异具有统计学意义,而在多形性腺瘤与腺泡细胞癌中的表达差异无统计学意义。CD9mRNA在多形性腺瘤中的阳性表达率高于腺样囊性癌,差异有统计学意义,而在多形性腺瘤和黏液表皮样癌、腺泡细胞癌中的表达差异无统计学意义;在多形性腺瘤中TN-CmRNA和CD9mRNA的表达呈正相关,在腺样囊性癌、黏液表皮样癌和腺泡细胞癌中TN—CmRNA和CD9mRNA的表达无相关性。结论：TN-CmRNA和CD9mRNA与涎腺肿瘤的发生有一定相关性,对涎腺肿瘤之间的鉴别诊断有一定意义。     

Intra-oral salivary gland neoplasms: a retrospective study of 98 cases

The findings of a retrospective study of 98 minor salivary neoplasms are reported. The patients' ages ranged from 13–79 years and there was an equal sex distribution. Sixty-one of the lesions were benign, 53 being pleomorphic adenomas and 8 monomorphic adenomas. Of the malignant tumors, 19 were mucoepidermoid tumors, 12 adenoid cystic carcinomas, 4 adenocarcinomas, 1 carcinoma ex-pleomorphic adenoma and 1 epidermoid carcinoma. One striking finding was the difference in age at the time of presentation for patients with muco-epidermoid tumors compared with those with adenoid cystic carcinomas. Seventy-four percent of the patients with muco-epidermoid tumors were under 50 years of age, but 75% of those with adenoid cystic carcinomas were over 50 years.     

Intra-oral salivary gland neoplasms: a retrospective study of 98 cases

The findings of a retrospective study of 98 minor salivary neoplasms are reported. The patient's ages ranged from 13-79 years and there was an equal sex distribution. Sixty-one of the lesions were benign, 53 being pleomorphic adenomas and 8 monomorphic adenomas. Of the malignant tumors, 19 were muco-epidermoid tumors, 12 adenoid cystic carcinomas, 4 adenocarcinomas, 1 carcinoma ex-pleomorphic adenoma and 1 epidermoid carcinoma. One striking finding was the difference in age at the time of presentation for patients with muco-epidermoid tumors compared with those with adenoid cystic carcinomas. Seventy-four percent of the patients with muco-epidermoid tumors were under 50 years of age, but 75% of those with adenoid cystic carcinomas were over 50 years.     

DNA ploidy analysis in salivary gland tumours by image cytometry

AIM: To determine whether DNA ploidy by image cytometry is a good diagnostic tool to distinguish benign and malignant salivary gland tumours. METHODS: A total of 62 salivary gland tumours were studied. Cases were histologically diagnosed [haematoxylin and eosin (H&E)]. According to the World Health Organization (WHO) classification, there were 14 mucoepidermoid carcinomas (MEC), 11 adenoid cystic carcinomas (ACC), 10 pleomorphic adenomas (PA), 10 carcinoma ex PA (CEPA), 9 acinic cell carcinomas (ACCa), 3 polymorphous low-grade adenocarcinomas (PLGA), 2 papillary cystadenocarcinomas (PC), 1 myoepithelial carcinoma (MC), 1 undifferentiated carcinoma (UC) and 1 mucinous adenocarcinoma (MA). Paraffin sections (40 microm) were micro-dissected to isolate tumour areas; cell nuclei were extracted and Feulgen-stained cytospin monolayers were analysed using a DNA image cytometry system. For each case, DNA index (DI) was calculated relative to internal controls (lymphocytes; DI=1.0). Cases were categorized as diploid or aneuploid and the proportion of cells over 5c was also calculated. RESULTS: Fifty-three of 62 salivary gland tumours were uniformly diploid. Only nine cases were aneuploid: five CEPA, one low-grade MEC, one PC, one UC and one MA. CONCLUSIONS: The vast majority of salivary gland tumours were diploid. High-grade malignancies may be aneuploid, and ploidy may be useful to identify malignant change in atypical PA. Further, larger studies are needed to confirm our results and to further evaluate the usefulness of the technique in high-grade lesions.     

PCNA, Ki-67 and p53 expressions in submandibular salivary gland tumours

Salivary gland tumours are uncommon with a broad heterogeneity. The most common benign tumour is the pleomorphic adenoma, whereas mucoepidermoid carcinoma and adenoid cystic carcinoma predominate among the malignancies. Most salivary gland tumours occur in the parotid, and consequently clinical and biological data are normally derived from this site. This work describes the expressions of PCNA, Ki-67 and p53 in 15 pleomorphic adenomas, 15 mucoepidermoid carcinomas and 15 adenoid cystic carcinomas of the submandibular gland. Our results showed that all pleomorphic adenomas were negative for p53 and Ki-67 with 66.6% being positive for PCNA. Conversely, p53 was positive in 53% of the mucoepidermoid carcinomas and in 20% of the adenoid cystic carcinomas. Ki-67 was expressed in 47.7% of the mucoepidermoid carcinomas and 40% of the adenoid cystic carcinomas. All malignant tumours were positive for PCNA. These results indicate that the proliferative rate analysed with PCNA and Ki-67 and the expression of p53 in pleomorphic adenoma and adenoid cystic carcinoma of the submandibular gland were similar to those described in the parotid and minor salivary glands. However, mucoepidermoid carcinomas showed higher expression of these markers than those of other salivary glands. This work is the first describing the expression of these immunohistochemical markers exclusively in submandibular salivary gland tumours.     

Relative frequency of intra-oral minor salivary gland tumors: a study of 380 cases from northern California and comparison to reports from other parts of the world

BACKGROUND: The relative frequency of individual intra-oral minor salivary gland tumors (IMSGT) is not well documented in the literature. The aim of this study was to determine the relative frequency and distribution of IMSGT in an oral pathology biopsy service and to compare the data with similar studies from different parts of the world. METHODS: Files from the Pacific Oral and Maxillofacial Pathology Laboratory of the University of the Pacific, San Francisco, California served as a source of material for this study. Files were systematically searched for all cases of IMSGT during a 20-year period. Tumors were classified according to the 2005 WHO classification of salivary gland tumors. RESULTS: IMSGT were identified in 380 (0.4%) cases of 92 860 accessed. This is the largest series of IMSGT from one source reported in recent years. Of the 380 tumors, 224 (59%) were benign and 156 (41%) were malignant. Of the benign tumors, pleomorphic adenoma (PA) was the most common (39.2%), followed by cystadenoma (6.3%), canalicular adenoma (6.1%), ductal papillomas (4.4%), basal cell adenoma (1.6%), and myoepithelioma (1.3%). Of the malignant tumors, mucoepidermoid carcinoma was the most common (21.8%), followed by polymorphous low-grade adenocarcinoma (7.1%), adenoid cystic carcinoma (6.3%), adenocarcinoma, not otherwise specified (NOS; 2.1%), acinic cell carcinoma (1.6%), clear cell carcinoma, NOS (1.0%), and carcinoma ex PA (0.5%). CONCLUSIONS: Studies related to the relative frequency of individual IMSGTs from different parts of the world are difficult to compare because many studies are outdated, the number of cases is small, the list of tumors is limited, and new entities are not included. To determine the true relative frequency, more studies should be conducted, on a large number of cases from one source, by experienced pathologists in the field of salivary gland tumors.     

Assessment of p63 expression in the salivary gland neoplasms adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, and basal cell and canalicular adenomas

PURPOSE: The purpose of this study was to determine the extent of p63 immunoreactivity in the malignant salivary gland neoplasms adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA) and to compare this to the expression of this marker in the benign salivary gland tumors canalicular adenoma and basal cell adenoma. Few studies on the expression of p63 in head and neck salivary gland tumors have been published to date. P63, a selective immunohistochemical marker of basal/stem cells of stratified epithelium and of myoepithelial cells, is a p53 homologue that plays an essential role in both morphogenesis of epidermis and limb development. P63 immunoreactivity has been demonstrated in squamous cell and urothelial carcinomas. It is generally absent in most nonsquamous cell carcinomas.Study design Formalin-fixed paraffin-embedded sections from 49 salivary gland neoplasms, representing 6 canalicular adenomas, 11 basal cell adenomas, 17 PLGA and 15 ACC accessioned from 1989 to 2002 by the Department of Pathology, Long Island Jewish Medical Center, New Hyde Park, NY, were stained with an anti-p63 monoclonal antibody. RESULTS: Nuclear p63 reactivity was uniformly positive in PLGA (17/17, 100%). Positive reactivity was also identified in the majority of cases of ACC (13/15, 87%), primarily in the nonluminal myoepithelial-like cells surrounding luminal cells. Canalicular adenoma did not exhibit any p63 immunoreactivity. All basal cell adenomas of parotid origin stained strongly for p63, with staining localized to the peripheral tumor cells situated adjacent to the connective tissue stroma. None of the basal cell adenomas originating in the upper lip stained with p63. In native adjacent salivary gland tissue, p63 reactivity was identified focally in the nuclei of myoepithelial and basal duct cells. CONCLUSIONS: P63 is strongly expressed in basal cell adenoma of parotid origin, and in ACC and PLGA. Canalicular adenoma did not demonstrate p63 staining, consistent with this tumor's putative luminal ductal cell differentiation. Our results suggest that the neoplastic cells in PLGA may represent either a population of p63-positive epithelial stem/reserve cells similar to the basal cells of stratified epithelium, or modified myoepithelial cells. Given the staining pattern of the tumors examined, p63 does not appear to be an ideal marker for distinguishing between ACC, PLGA, and basal cell adenoma.     

150例涎腺癌的临床分析

分析150例涎腺癌,发生在腮腺61例,颌下腺14例,舌下腺5例,和小唾腺70例。病理分型:癌在多形性腺瘤中49例,腺癌25例,腺样囊性癌24例,粘液表皮样癌22例,腺泡细胞癌22例,鳞状细胞癌5例,乳头样囊腺癌2例,未分化癌1例。150例涎腺癌3、5、10年生存率为80.7％、69.4％、52.1％。腺泡细胞癌和粘液表皮样癌预后较鳞状细胞癌、腺癌和未分化癌好。生存率根据部位,小唾液腺和腮腺肿瘤最高,舌下腺和颌下腺最低。术后放疗和化疗,对涎腺癌,生存率是重要的,涎腺癌复发率为27.6％,颈淋巴结转移率为9.2％。     

神经营养因子-3在涎腺腺样囊性癌中的表达及其意义

目的 :通过检测神经营养因子 -3 (NT -3 )在涎腺腺样囊性癌 (ACC)的表达情况 ,探讨NT -3与ACC嗜神经侵袭的关系。方法 :以 3 2例ACC、7例正常腮腺及 3例腺泡细胞癌标本为研究对象 ,采用免疫组化法对NT -3进行检测。结果 :NT -3在正常腮腺的导管细胞表达为阳性 ;在腺泡细胞癌为阴性 ;在ACC病例中的阳性率为 93 .8% ( 3 0 /3 2 )。按病理学表现分组时 ,存在嗜神经现象组的NT -3表达水平明显高于未见嗜神经现象组 (P <0 .0 5 )。存在嗜神经现象组的大部分切片中神经束普遍较相应的正常腮腺组织或腺泡细胞癌密集 ,且有 4例ACC可见沿神经周分布的肿瘤细胞的染色强度明显高于远离神经者。结论 :NT -3可能作为ACC嗜神经侵袭的生物学标志。ACC中NT -3表达的增强可能是促进其嗜神经侵袭的原因之一     

65例恶性成分为非特异性腺癌的涎腺恶性多形性腺瘤临床病理特点

目的 研究分析恶性成分为非特异性腺癌的涎腺恶性多形性腺瘤(malignant pleomorphic adenoma,MPA)的临床病理特点,以期为临床诊断和治疗提供参考.方法 回顾性分析115例原发MPA的临床病理资料,应用统计学软件分析恶性成分为非特异性腺癌和其他组织学类型病例在临床病理特点方面的差异,分析恶性成分为非特异性腺癌病例的临床病理指标与颈淋巴结转移的相关性.结果 恶性成分为非特异性腺癌的65例原发MPA中,男性58例,女性7例;发病年龄23～83岁,平均57岁,50～59岁最好发;发生于大涎腺61例,小涎腺4例;组织学分级为低、中、高度恶性者分别为12、14、39例;非侵袭性、微侵袭性、侵袭性MPA分别为15、13、37例;13例发生颈部淋巴结转移.恶性成分为非特异性腺癌的原发MPA组织学分级与侵袭性呈显著正相关(P＜0.05);侵袭性与TNM分期呈显著正相关(P＜0.05);侵袭性和组织学分级与颈部淋巴结转移之间有显著相关性(P＜0.05).结论 MPA恶性成分组织学类型最常见为非特异性腺癌,组织学分级越高,肿瘤的侵袭性越强;侵袭性癌、组织学分级高度恶性者易发生淋巴结转移.

Abstract：

Objective To analyze the clinicopathologic features of salivary malignant pleomorphic adenoma(MPA)(the subtype of the malignant component was classified as non-specific adenocarcinoma). Methods The clinical and pathological characteristics of 115 salivary gland tumors histologically diagnosed as MPA were analyzed. Results In all the 65 MPA cases, there were 58 male and 7 female patients, and the mean age was 57 years(from 23 to 83). Sixty-one tumors were located in major salivary glands, and 4 in minor. Histologically the malignant components of 39 tumors were high-grade, 14 intermediate-grade, and 12 low-grade. Thirty-seven tumors were invasive carcinoma, 13 minimally invasive, and 15 non-invasive. The high-grade tumors had positive correlation with the invasive carcinomas(P＜0.05). The invasive carcinomas had positive correlation with TNM clinical stage(P＜0.05). The invasive carcinoma and the high-grade tumor had correlation with cervical lymph node metastasis (P＜0.05).Conclusions Non-specific adenocarcinoma are the most common malignant subtype in MPA. The invasive and the high-grade types are more likely to metastasize to cervical lymph node.     

Hybrid tumours of salivary glands. Definition and classification of five rare cases

Hybrid tumours are very rare tumour entities which are composed of two different tumour entities, each of which conforms with an exactly defined tumour category. The tumour entities of a hybrid tumour are not separated but have an identical origin within the same topographical area. In contrast, biphasically differentiated tumours are a mixture of two cellular patterns with a corresponding term in the tumour classification. Examples of a biphasic differentiation are: basaloid-squamous carcinoma, adeno-squamous carcinoma or sarcomatoid carcinoma, and epithelial-myoepithelial carcinoma, mucoepidermoid carcinoma or adenoid cystic carcinoma. Hybrid tumours must also be distinguished from the multiple occurrence of salivary gland tumours which can develop syn- or metachronously. In the tissue samples of more than 6600 salivary gland tumours covered by the Salivary Gland Register (Institute of Pathology, University of Hamburg, Germany) only 5 cases of hybrid tumours were recorded between 1965 and 1994. This means less than 0.1% of all registered tumours. Case 1 was a very rare example of a hybrid adenoma with differentiation as a basal cell adenoma and a canalicular adenoma of the parotid gland. The similar cellular origin of both types of adenoma may be an explanation for its development into a hybrid adenoma. Case 2 is a hybrid tumour with a composition of basal cell adenoma and a glandular type of adenoid cystic carcinoma. In both types of tumours the two cell types (duct-lining cells and modified myoepithelial cells) have a similar histogenetic origin. Therefore, the development of both cell types in a hybrid tumour with two trends of differentiation is possible. Case 3 represents a hybrid adenoma as a mixture of a Warthin tumour and a sebaceous adenoma. Although inclusions of sebaceous cells are observed in Warthin tumours, this hybrid tumour shows a composition of two different epithelial structures in a varied mixture. Case 4 is a very rare and unique hybrid carcinoma with two absolutely different components: acinic cell carcinoma and salivary duct carcinoma. The poor prognosis of this hybrid carcinoma is determined by the salivary duct carcinoma. Case 5 represents a hybrid carcinoma whose two components have a similar histogenetical basis: epithelial-myoepithelial carcinoma and a glandular type of adenoid cystic carcinoma. Both carcinomas are composed of variable proportions of ductlining cells and myoepithelial cells.     

Tumor-associated glycoprotein 72 (TAG-72) expression in salivary gland neoplasia: an immunohistochemical study using the monoclonal antibody (MAb) CC49

OBJECTIVES: The purpose of this study was to investigate immunohistochemically the expression of tumor-associated glycoprotein 72 (TAG-72) using the monoclonal antibody (MAb) CC49 in salivary gland neoplasia and normal salivary glands in an attempt to determine the potential usefulness of MAb CC49 in diagnostic and therapeutic applications. MATERIALS AND METHODS: Eighty-six specimens (21 benign tumors, 41 malignant, and 24 normal salivary glands), fixed in 10% formalin and embedded in paraffin, were retrieved from the files of the Department of Oral Medicine and Oral Pathology at the Dental School of Aristotle University, Thessaloniki, Greece, and were retrospectively studied with hematoxylin and eosin and with the streptavidin-biotin-complex method using the MAb CC49. RESULTS: Strong immunoreactivity for TAG-72 was observed in salivary duct carcinoma, adenocarcinoma, papillary cystadenocarcinoma, low-grade mucoepidermoid carcinoma, normal submandibular, sublingual, and minor salivary glands. Weak or no immunoreactivity was found in adenoid cystic carcinoma, basal cell adenocarcinoma, polymorphous low-grade adenocarcinoma, and normal parotid gland. CONCLUSIONS: Our results suggest the potential use of MAb CC49 in the differential diagnosis of some salivary gland neoplasms in which their histopathologic features overlap, and in the radiation immunolocalization and immunotherapy of malignant tumors that are localized in the parotid gland.     

DNA flow cytometry of reclassified subtypes of malignant salivary gland tumors

Malignant salivary gland tumors are rare, constitute a heterogeneous group and are often difficult to diagnose histologically. This is borne out by the fact that in the present study 43.2% of 118 salivary gland tumors originally diagnosed as mucoepidermoid, acinic cell and adenoid cystic carcinomas had their original diagnosis altered upon reclassification. Patients with confirmed adenoid cystic carcinomas had a much worse prognosis than those with mucoepidermoid and acinic cell carcinomas.
DNA flow cytometry showed that very few of the above mentioned three types of malignant neoplasms revealed aneuploid DNA stemlines, indicating that this is not a relevant prognostic tumor marker within the groups. However, several of the tumors that had their diagnosis changed, mostly to undifferentiated adenoor squamous cell carcinomas, showed aneuploid DNA stemlines. The survival time of patients with aneuploid tumors was considerably reduced compared to those with diploid tumors. Among confirmed acinic cell, mucoepidermoid and adenoid cystic carcinomas the S-phase fraction was a significant prognostic factor, as it was among all tumors examined. This indicates that DNA aneuploidy and S-phase fractions are potential prognostic factors for malignant salivary gland tumors, and that DNA flow cytometry may assist the characterization of such tumors.     

Neural adhesion molecule (N-CAM) in pleomorphic adenoma and carcinoma ex-pleomorphic adenoma

BACKGROUND: The neural cell adhesion molecule (N-CAM) has been implicated in the behaviour of the adenoid cystic carcinoma. In vitro, it was demonstrated that N-CAM inhibits cell invasion. The aim of this study was to search for N-CAM in the most common salivary gland tumour that has a malignant counterpart. METHODS: We investigated the presence of N-CAM in pleomorphic adenoma and its malignant counterpart, the carcinoma ex-pleomorphic adenoma, using the immunohistochemistry technique. RESULTS: Neural cell adhesion molecule was expressed in all cases of pleomorphic adenoma, strongly labelling the luminal cells of the double-layered ductform structures. This expression was weaker in neoplastic myoepithelial cells and progressively diminished at a distance from the luminal cells. In carcinoma, ex-pleomorphic adenoma N-CAM was either totally absent or faintly present at the apical pole of the few luminal cells. CONCLUSIONS: As a result of the peculiar distribution of N-CAM in pleomorphic adenoma, we speculated that N-CAM behaves as a tumour-suppressor molecule, which is expressed in the benign neoplasm and which is down-regulated after malignancy, when the tumour assumes an invasive behaviour.     

Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population

There is little information in the English-language literature about the epidemiology of salivary gland neoplasms in the eastern Chinese population. A large retrospective study (6982 primary salivary tumors during 23 years) was carried out to investigate the clinicopathological features (tumor location, patient sex and age) of these tumors in this population. 3593 tumors were in males and 3389 in females. Pleomorphic adenoma (69%) was the most common tumor and 20% were located in minor glands. 92% of Warthin's tumors occurred in males. Malignant tumors were predominantly adenoid cystic carcinoma (30%) and mucoepidermoid carcinoma (30%). Incidences of lymphoepithelial carcinomas (5%) and polymorphous low-grade adenocarcinoma (1%) of malignant tumors were identified. 28% of tumors originated from minor glands. Most findings were similar to those in the literature, with some variations. The salivary tumors slightly predominated in males. Relatively higher incidences of minor gland tumors and specifically of pleomorphic adenoma in minor glands were noted. Adenoid cystic carcinoma and mucoepidermoid carcinoma constituted the most common malignancies. There was a high incidence of lymphoepithelial carcinomas but a low incidence of polymorphous low-grade adenocarcinoma. The historical significant male predominance of Warthin's tumor was confirmed.     

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     

Simultaneously occurring salivary gland tumors of different types.

Two cases of simultaneously occurring salivary gland tumors of the parotid gland are reported. Both patients were women in the sixth decade of life. In the first patient, a carcinoma in pleomorphic adenoma and an oncocytoma were found in the right parotid gland. The second patient had an adenoid cystic carcinoma associated with a sebaceous cell adenoma. The addition of these cases to the previously published data brings the total number of simultaneously occurring salivary gland tumors of different types to ten.     

Basal cell adenoma of the parotid gland. Case report and review of the literature

Basal cell adenoma of the salivary glands is an uncommon type of monomorphous adenoma. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, isomorphic cells in nests and interlaced trabecules with a prominent basal membrane are observed. It is also characterized by the presence of a slack and hyaline stroma and the absence of myxoid or condroid stroma. In contrast to pleomorphic adenoma, it tends to be multiple and its recurrence rate after surgical excision is high. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is mandatory. We describe a case of basal cell adenoma of the parotid gland. We also review the literature and discuss the diagnosis and management of this rare entity.     

Expression of PLUNC family members in benign and malignant salivary gland tumours

Objectives: The aim of this study was to determine the expression of PLUNC proteins in benign and malignant salivary gland tumours and thus their potential use as diagnostic and / or prognostic tools. Materials and methods: A tissue microarray was assembled from 64 salivary gland tumours including adenoid cystic carcinoma, carcinoma ex‐pleomorphic adenoma, mucoepidermoid carcinoma, polymorphous low‐grade adenocarcinoma, pleomorphic adenoma, acinic cell carcinoma, myoepithelial carcinoma and papillary cystadenocarcinoma. Clinicopathological data were collected retrospectively and immunohistochemical analysis of three PLUNC proteins (SPLUNC1, SPLUNC2 and LPLUNC1) was performed. Immunoreactivity was assessed as positive or negative. Results: PLUNC expression was only found in mucoepidermoid carcinomas and papillary cystadenocarcinoma; all other tumours studied were negative. Mucin plugs, mucous and intermediate cells of mucoepidermoid carcinomas were positive for LPLUNC1 and SPLUNC2, but areas composed of epidermoid and clear cells were negative for all PLUNCs. Papillary cystadenocarcinoma was positive for all PLUNCs. No correlation was found with tumour grade or outcome. Conclusions: Intense expression of two PLUNC proteins in mucous cells and mucin plugs of mucoepidermoid carcinoma and papillary cystadenocarcinoma indicate that they could be used as additional diagnostic tools in some equivocal cases, but further studies are needed to understand the biological processes involved in PLUNC expression.     

The role of neck dissection in the eradication of salivary carcinomas]

From 1955 to 1984, radical neck dissection (RND) had been done in 300 salivary carcinoma patients, 114 of which had regional lymph node metastasis, with a 38% metastatic rate. Respective 3, 5, 10, 15, 20 year survival rates were 76, 64, 47, 35, 35% in a 3 to 20 years follow-up study in 283 patients (94.33%). The following four points are concluded: 1. The metastatic rate is determined not only on tumor staging, but more to its typing (pathologic behaviour). 2. Elective RND gave a better prognosis than therapeutic and negative metastasis has a better survival chance than positive where the low level metastasis is the worst. 3. According to pathologic typing, Elective RND is indicated for undifferentiated adenocarcinoma, high malignant mucoepidermoid carcinoma, squamous cell carcinoma, adenocarcinoma and papillary cystic adenocarcinoma, therapeutic RND for malignant pleomorphic adenoma, acinic cell carcinoma and mucoepidermoid carcinoma. 4. Unilateral RND is indicated for all but sublingual and buccal tumors.