Adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland

We described an extremely rare case of adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland of a 40-year-old Japanese woman. The tumor was growing from the cyst wall and almost occluded the cyst lumen. The epithelium lining the cyst lumen contained both keratin 19-positive cells and alpha-smooth muscle actin-positive cells, indicating the cyst being derived from the acinus/intercalated duct of the sublingual gland. Therefore, our case has presented for the first time a direct evidence that adenoid cystic carcinoma arises from acinus/intercalated duct.     

In vitro adherence of rat lymphocytes to salivary gland epithelia

Glandular mucosal tissues contain lymphocyte populations that contribute to expression of IgA antibodies in external secretions. Interaction of circulating lymphocytes with glandular structures may regulate lymphocyte accumulation. An in vitro assay was used to investigate adhesive interactions between lymphocytes and salivary gland tissues. Thoracic duct lymphocytes (TDL) bound to the serous acinar epithelia of parotid salivary glands and to the mucous tubulo-acinar epithelium of submandibular salivary glands. Lymph node cells and splenocytes adhered to these tissues in lesser numbers and thymocytes bound in negligible numbers. TDL adherence was an active process, being time- and cell dose-dependent and requiring intact membrane as well as cytoskeletal and metabolic function. Calcium was required in each case and binding was mediated by a trypsinsensitive lymphocyte surface determinant. These findings suggest that the lymphocyte composition of salivary gland tissues is regulated by active lymphocyte interaction with the glandular epithelium.     

Fine needle aspiration cytology of salivary gland lesions

247 salivary gland lesions were subjected to fine needle aspiration (FNA) cytology; 179 were designated as neoplastic lesions and 68 as non-neoplastic. Based on cytomorphologic features, the neoplastic and non-neoplastic lesions were subcategorised. All but 36 of the neoplastic lesions were subjected to histopathologic study. The overall diagnostic accuracy of FNA cytology for neoplastic lesions was 91%. The sensitivity rate for detecting malignant tumours was 87.8% and the specificity 98.0%. There was 100% sensitivity for cytodiagnosis of benign tumours. The high sensitivity and specificity of cytodiagnosis makes FNA cytology a valuable diagnostic modality in the evaluation of salivary gland lesions.     

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涎腺疾病包括涎腺肿瘤及非肿瘤性涎腺疾病.涎腺主要依靠其分泌液--唾液发挥功能.近些年来,涎腺疾病和唾液的研究方面取得了明显的进展,本文对其中部分进展作一概述.     

涎腺黏液腺癌1例

黏液腺癌是一种少见的上皮性恶性肿瘤,好发于阑尾、胰腺、乳腺等部位,发生于涎腺者罕见。本文报道1例发生在涎腺的黏液腺癌,并对相关文献进行复习。     

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涎腺肿瘤是口腔颌面部较为常见的肿瘤,约占全部口腔颌面肿瘤疾患的1/5,其中上皮源性肿瘤占多数,其他组织来源(如间叶组织)肿瘤则比较少见.如同卵巢肿瘤,涎腺肿瘤的病理类型十分复杂,生物学行为也大相径庭.     

Acute salivary gland hypofunction in the duct ligation model in the absence of inflammation

Objective:  The commonly associated aetiology of salivary gland inflammation and salivary hypofunction has led to the widely held belief that inflammation causes salivary gland hypofunction. Indeed, our own recent study seemed to support this contention. Here, we tested the hypothesis that, in an acute duct ligation model, eliminating inflammation the submandibular gland would recover normal function.
Materials and methods:  Ligation of the rat submandibular gland excretory duct for 24 h was used to induce inflammation and salivary gland hypofunction. A group of duct ligated rats was compared with a second group given dexamethasone, on the day of duct ligation. Twenty-four hours later salivary gland function was assessed and salivary glands were collected.
Results:  Histology and myeloperoxidase activity assay revealed a profound decrease in inflammatory cell infiltration of ligated glands from rats given dexamethasone, compared with ligated glands in the absence of dexamethasone. Salivary flow rate evoked by methacholine was decreased ( P  < 0.01) by approximately 56% (ligated vs control, 79 ± 9  μ l min⁻¹ g⁻¹ vs 177 ± 11  μ l min⁻¹ g⁻¹) and salivary flow from ligated dexamethasone-treated and ligated glands was similar.
Conclusion:  Despite eliminating the inflammatory reaction in the ligated gland, salivary hypofunction was not reversed, suggesting that other mechanisms must be at work in the ligation-induced salivary hypofunction.     

小涎腺局灶性增生的临床病理观察

目的：涎腺局灶性增生为发生于口腔小涎腺的少见病,临床常误诊为良性肿瘤或其他病变,为提高临床病理诊断水平,本文进行了总结。方法：复习628例小涎 肿瘤及瘤样病变的病理切片中,有9例属于本病。结果：9例的发生部位以腭部最多见（4／9）,其次为上唇（2／9）、颊、磨牙后垫及舌各1例,临床表现增生物较小,为柔软的实性团块,与周围组织之间无明显界限。病理表现为大量粘液腺泡的聚集,腺导管基本正常,无炎症或散在少量慢性炎症细胞,偶见少量腺泡的细胞膜消失,腺泡融合,增生物与周围腺体之间无明显界限。结论：本病临床表现为缓慢增生的肿块,作为准确诊较困难,只有手术后病理检查才能确诊。     

Cell culture and characterization of human minor salivary gland duct cells

In order to facilitate studies on human salivary glands, a method was developed for the culture of minor salivary gland duct cells from tissues obtained from oral surgery protocols. Minor salivary glands were isolated from such tissues, and a serum-free growth medium was developed which supported the growth of the ductal component of these glands. The ductal origin of these cells was confirmed through immunohistochemical localization of replicating nuclei through incorporation of BrdU. The presence of epidermal keratin in replicating cells and the absence of smooth muscle myosin further substantiated the ductal origin of cells. Using normal growth medium calcium concentrations (1.05 mM), these cells produced a keratinized multilayer of cells unable to undergo routine subculture procedures. A reduction in calcium ion concentration to 0.1 mM resulted in a cell monolayer, without evidence of terminal keratinization, which could undergo at least eight serial passages (1:3 ratio) under cell culture conditions. It is advanced that these minor salivary gland duct cell cultures will be of use to those studying diseases and disorders of the salivary glands.     

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目的探讨涎腺导管癌(SDC)的病理特点,为临床诊断提供帮助。方法结合2005年1月至2007年6月中国医科大学口腔医学院收治的4例SDC患者的临床资料,复习国内文献中其余56例病例,对比分析SDC的临床特点。结果SDC以腮腺多见,男性多于女性,神经受累现象出现较早,淋巴结及远隔转移多见。结论SDC是一种高度恶性肿瘤,临床应注意鉴别诊断。     

A clinicopathologic study of 196 intraoral minor salivary gland tumours

We present a retrospective study of 196 patients with intraoral minor salivary gland tumours, 128 malignant and 68 benign, diagnosed from 1954 to 1993 in the A.C. Camargo Hospital, São Paulo, Brazil. Sixty-five percent of the cases occurred in the palate, followed by tongue (9.7%) and retromolar area (6.1%). Pleomorphic adenoma was the most common benign tumour, and mucoepidermoid carcinoma was predominant among the malignant tumours. Surgery was the main treatment method and postoperative radiotherapy and radiotherapy alone were used in 40 and 15 patients, respectively. Local recurrence was observed in two patients with pleomorphic adenoma and in eight patients with malignant tumours. Regional lymph node metastases occurred in four cases and distant metastases in five. Forty-six of 47 patients with benigh tumours who were followed up from 1 to 7 years were alive without disease. Twenty-four of 79 patients with malignant tumours who were followed up for at least 5 years died due to the tumour and 47 were alive without disease.     

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涎腺上皮性肿瘤组织病理学结构具有器官特异性,典型的多形性腺瘤、Warthin瘤、黏液表皮样癌和腺样囊性癌等肿瘤病理诊断较容易。涎腺肿瘤有多种病理学类型,且     

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内镜(endoscopy)技术,如腹腔镜、关节镜等目前已广泛应用于临床.在口腔颌面外科领域,过去主要应用于颞下颌关节病的诊断与治疗.自20世纪90年代以来,内镜技术的应用范围进一步扩展,已逐步应用于涎腺疾病的诊治.     

Expression of mitotic checkpoint proteins BUB1B and MAD2L1 in salivary duct carcinomas

J Oral Pathol Med (2010) 39 : 349–355 Objective: Defects in the mitotic checkpoint lead to aneuploidy and might facilitate tumorigenesis. However, the ploidy status in salivary duct carcinoma (SDC) has been reported to play limited role in prediction of prognosis. Thus, we need more reliable markers to reflect the rapid tumor progression in SDCs. We aimed here to investigate the expression of mitotic checkpoint proteins benzimidazole 1 homolog beta (BUB1B) and mitosis arrest‐deficient 2 like 1 (MAD2L1) in SDCs and to determine their possible role as surrogate prognostic markers. Methods: We analyzed the clinical courses, pathologic findings and immunohistochemical profiles of mitotic checkpoint proteins (BUB1B and MAD2L1) in 27 pathologically confirmed SDCs. The expression status of BUB1B and MAD2L1 was compared with clinicopathologic factors and other molecular markers, such as TGF‐beta, c‐erb‐B2, androgen receptor, vascular endothelial growth factor, and epidermal growth factor receptor, for prognostic significance. Results: High BUB1B expression was detected in 25.9% of subjects, and high MAD2L1 expression was in 55.6% of subjects. However, survival analysis revealed that mitotic checkpoint expression did not have prognostic significance in SDCs, nor did the other studied markers. Rather, the clinical variable of N classification at diagnosis (in N+ status, hazard ratio 5.19, 95% CI 1.26–21.32 for disease‐free survival and hazard ratio 7.18, 95% CI 1.09–46.99 for overall survival) was strongly associated with survival and prognosis based on the Cox proportional hazard model. Conclusions: Mitotic checkpoint proteins appeared to play a limited role in predicting prognosis in SDCs. Further study is required to elucidate the exact role of mitotic checkpoint proteins in SDCs.     

3种方法治疗涎腺黏液囊肿的临床研究

目的评价应用微波治疗、平阳霉素硬化疗法、手术切除3种方法对涎腺黏液囊肿的治疗效果。方法共纳入123例涎腺黏液囊肿患者,按照其接受的治疗情况被分为微波治疗组（35例）、平阳霉素硬化治疗组（40例）、手术切除组（48例）,分别采用相应治疗。治疗后半年随访并观察疗效。结果3组患者基线指标差异无统计学意义。所有患者均得到随访。微波治疗组治愈率94．29％,平阳霉素硬化治疗组治愈率95．00％,手术切除组治愈率95．83％;3种治疗方法疗效差异无统计学意义（P〉0．05）。结论微波治疗和平阳霉素注射治疗是手术治疗涎腺黏液囊肿的有效补充,可以用于幼儿及不能耐受或不愿手术的患者的治疗中。     

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目前,涎腺肿瘤最终手术方案的制定主要依赖术中组织冰冻切片诊断.对于病理医生来说,术中组织冰冻切片诊断的要求是确定涎腺肿瘤的良、恶性以及恶性程度.而并不一定要明确肿瘤的具体类型.观察肿瘤的生长方式,即肿瘤有无包膜、是否呈浸润性生长以及浸润状况是判断涎腺肿瘤良恶性的主要依据之一,对于某些类型涎腺肿瘤来说,浸润性生长可能是支持其为恶性的唯一证据.熟悉临床资料,做好组织冰冻巨检和取材工作.保证组织冰冻制片质量均有助于保证及提高组织冰冻切片诊断准确性.     

人β-防御素-2在涎腺肿瘤及涎腺炎症中的表达及其意义

目的 研究涎腺良性肿瘤组织、恶性肿瘤组织和涎腺炎症中人β-防御素-2（HBD-2）mRNA和蛋白的表达特征。方法 对不同涎腺组织,采用聚合酶链反应（PCR）、实时聚合酶链反应（Real-Time PCR）和免疫组化检测HBD-2的表达,并分析HBD-2 mRNA和蛋白在涎腺良性肿瘤组织、恶性肿瘤组织、炎症组织和正常涎腺组织中的表达差异。结果 与涎腺正常组织比较,良性肿瘤组HBD-2 mRNA表达量为其6.468倍,显著高于涎腺正常组织组（P<0.05）;恶性肿瘤组为其0.334倍,显著低于涎腺正常组织组（P<0.05）;涎腺炎症组为其10.563倍,显著高于涎腺正常组织组（P<0.05）。HBD-2不仅在这些组织的细胞质中有表达,而且在恶性组织中的细胞核也有表达。结论 HBD-2在涎腺良性肿瘤组织及涎腺炎症组织中高表达,在涎腺恶性肿瘤组织中低表达,其蛋白发生核转移。     

基质金属蛋白酶-1在人涎腺腺样囊性癌细胞中的表达

目的:测定基质金属蛋白酶-1(MMP-1)在人涎腺腺样囊性癌不同转移力细胞系中的表达。方法:以人涎腺腺样囊性癌ACC-2细胞系及其高转移株ACC-M作为研究肿瘤转移分子机制的模型,采用免疫组化法和蛋白印迹(Western blot)法检测MMP-1的蛋白表达水平。结果:MMP-1在ACC-M细胞中的表达水平高于ACC-2细胞。结论:MMP-1在人涎腺腺样囊性癌的侵袭转移过程中可能发挥作用。     

4种涎腺肿瘤及人胚颌下腺免疫组化对比研究

目的：探讨涎腺肿瘤细胞的形态分化、组织发生及其异质性。方法：采用光镜、免疫组化技术对８例腺淋巴瘤、３例嗜酸性腺瘤、１２例多形性腺瘤及２例上皮－肌上皮癌进行研究,同时观察了５６例胚胎颌下腺组织作为对照。结果：多形性腺癌中导管样结构系肿瘤性闰管结构和肿瘤性分泌管结构;腺淋巴瘤和嗜酸性腺瘤中导管结构系肿瘤性分泌管结构;上皮－肌上皮癌中导管结构系肿瘤性闰管结构;涎腺肿瘤组织结构及抗原表达复杂多样,与人胚涎腺发生过程中结构及抗原表达有相似之处。结论：涎腺肿瘤的复杂性系致瘤因素作用于不同干细胞或同一干细胞不同分化阶段所致。