104例涎腺肿瘤的临床分析

通过分析104例涎腺肿瘤的临床表现、诊断及治疗,发现男女患者的比值为1:1.21;良性肿瘤80例,占76.9％;恶性肿瘤24例,占23.0％;良性肿瘤多见于21～50岁组(63.25％),主要为混合瘤、腺淋巴瘤;恶性肿瘤多见于51～60岁组(58.33％),主要为粘液表皮样癌、恶性混合瘤、腺样囊性癌;肿瘤的好发部位依次为:腮腺部、颌下腺部、小涎腺部及舌下腺部。其中腮腺及颌下腺部良性肿瘤高于恶性肿瘤;小涎腺中的恶性肿瘤比重大大增加。诊断中强调了细针吸细胞学检查的价值,并对肿瘤的手术原则及预后作了讨论。     

改良耳后切口在黏液表皮样癌腮腺全切术中的应用

<正>黏液表皮样癌(mucoepidermoid carcinoma)是涎腺中最常见的恶性肿瘤,占所有涎腺肿瘤的3%～15%,在大涎腺肿瘤中约占5%～10%。我科应用改良耳后切口行腮腺及肿瘤全切术,取得了良好的临床效果,现总结如下。1资料和方法1.1一般资料:2009年3月至2012年3月,于清远市人民医院口腔颌面外科住院,诊断为腮腺黏液表皮样癌19例,其中男性10例,女性9例,年龄14～68岁,平均(54±21)岁。     

涎腺恶性淋巴瘤附6例报告

原发于延腺的恶性淋巴瘤少见,涎腺恶性淋巴瘤占涎腺肿瘤1～5%[1].我院自1987年至2000年共收治了6例腮腺淋巴瘤,占同期涎腺肿瘤的1.6%(6/364),现报告如下,并结合文献就涎腺淋巴瘤的临床生物特点,病理类型及治疗作出讨论.     

彩色多普勒影像在涎腺肿瘤中的诊断价值

目的:研究涎腺肿瘤的彩色多普勒影像表现,探讨彩色多普勒影像对涎腺肿瘤的评估价值.方法:选取125例经病理证实的涎腺肿瘤患者的术前超声检查图像及病理组织,并运用免疫组织化学技术S-P法对活检切除的标本进行检测.分析涎腺肿瘤的某些彩色多普勒特征性图像.结果:依靠二维超声的特征性表现判断涎腺肿瘤的良恶性有一定的特异性,涎腺肿瘤中良恶性肿瘤的超声特征性表现具有统计学意义(P＜0.05);涎腺良恶性肿瘤内部彩色多普勒血供之间差异具有统计学意义(P＜0.05),但对于无血流信号的小肿瘤也排除不了恶性的可能性,如果能同时结合肿瘤内多普勒血流参数就可以大大提高肿瘤良恶性的诊断准确性.结论:涎腺瘤良恶性与彩色多普勒超声特征性表现有一定的相关性呈正相关.     

颌下腺癌38例临床分析

<正>颌下腺是涎腺中第2对大腺体,颌下腺癌的发生率高于腮腺,良恶性肿瘤约各占50%,或恶性略多于良性。现将我院1999—2005年收治的38例颌下腺癌的临床资料做一总结分析,以提高颌下腺癌的临床治疗效果。     

PLAG1在涎腺肿瘤中表达的初步研究

目的检测涎腺肿瘤(salivary gland tumour)中多形性腺瘤基因1(pleomorphic adenoma gene 1,PLAG1)的表达,探讨PLAG1在涎腺常见良、恶性肿瘤以及涎腺多形性腺瘤中的表达异同及意义。方法选取2011年8月至2012年4月间贵阳医学院附属医院口腔颌面外科经手术切除病理证实的涎腺肿瘤组织标本20例,采用免疫组织化学SABC法检测PLAG1在20例不同涎腺组织中的表达。结果 PLAG1在多形性腺瘤中阳性表达最高,其次为涎腺良性肿瘤,在涎腺恶性肿瘤中的表达最低,差异具统计学意义(P<0.05)。结论PLAG1在涎腺恶性肿瘤中阳性表达低于在涎腺良性肿瘤中,其中又以多形性腺瘤高阳性表达尤为突出,可能因为多形性腺瘤的细胞核型中大部分细胞都发生了染色体的重排,瘤细胞中有特殊的靶基因存在,导致PLAG1的高表达;提示PLAG1在不同类型涎腺肿瘤中的表达有其一定规律,PLAG1可能被激活途径不同及特定肿瘤中的特殊靶基因存在导致不同类型肿瘤的发生,找寻PLAG1被激活途径并阻断激活通路、及对PLAG1靶基因的研究发现可能成为治疗涎腺肿瘤的新途径。     

涎腺肿瘤的外科手术治疗

目的探讨涎腺肿瘤的外科手术治疗方法。方法对91例涎腺肿瘤患者的临床资料进行回顾性分析,观察其发病部位,术后疗效及并发症情况。结果涎腺肿瘤发病部位以腮腺为最多,占51.6%(47/91),依次为腭部23.1%(21/91),颌下腺19.8%(18/91),舌下腺3.3%(3/91)。91例涎腺肿瘤患者,术后随访1～3年,3例患者于术后复发,涎腺恶性肿瘤死亡2例。余患者随访1～3年均存活,无复发。无眼睛闭合障碍和口角歪斜等并发症发生。结论根据患者的具体病情,采用适当的手术方法,能彻底地切除病灶,减少并发症的发生。     

215例涎腺肿瘤临床分析

涎腺肿瘤较常见,约占全身肿瘤发病率的2％,主要发生于大涎腺,215例涎腺肿瘤中大涎腺占173例,小涎腺占42例。临床资料 (一)性别与年龄:本组男102例,女113例;年龄,良性肿瘤平均35岁,恶性肿瘤平均50岁。 (二)病期与表现:涎腺肿瘤生长缓慢,本组良性肿瘤平均病期7～8年,恶性的平均病期2年。主     

腮腺鳞状细胞癌行腮腺全切术保留面神经一例

涎腺鳞状细胞癌是很少见的一种涎腺癌,主要发生在腮腺,其它较小的涎腺是很少发生的。笔者收治一例并在保留面神经的情况下使腮腺鳞状细胞癌得到了根治.介绍如下.患者,女性,27岁,于1991—04—13以右侧腮腺区肿物3个月入院治疗.查体见肿物3.0cm×4.3cm.质地较硬,呈结节状,肿物固定浸润性生长.术前根据此病例的病程短,生长速度快,活动度差,考虑为腮腺恶性肿瘤可能性大.此处的恶性肿瘤本应行肿瘤及面神经切除局部淋巴结扩清术.但因未有局部淋巴结转移,未作术前病理,患者本人及家属坚决要求保留面神经,拒绝淋巴结扩清术.所以选用了“腮腺及肿物全切除术保留面神经”,术中可见肿瘤包膜不完整,边界不清楚,与周围     

口腔小涎腺肿瘤87例临床分析

目的探讨口腔小涎腺肿瘤的临床诊治特点。方法对本科1 9 9 5~2 0 0 5年经病理确诊的8 7例口腔小涎腺肿瘤的临床资料进行回顾性分析。结果 8 7例口腔小涎腺肿瘤,良性肿瘤6 2例,占7 1.2 6%;恶性肿瘤2 5例,占2 8.7 4%。良性肿瘤均为混合瘤,恶性肿瘤中以腺样囊性癌多见,占恶性肿瘤的4 4.0 0%,8 7例均行手术治疗,恶性肿瘤5年生存率为8 8.8 2%。结论口腔小涎腺肿瘤中良性肿瘤多于恶性肿瘤。外科手术是口腔小涎腺肿瘤的主要治疗方法,恶性肿瘤可行手术＋术后辅助放疗的综合治疗。     

Pattern of salivary gland tumors in Ethiopia and non-western countries

Report from various parts of the world indicate that there are differences in the total incidence of salivary gland tumors as well as in the frequency of particular histologic types and in the frequency with which major and minor salivary glands are involved; Moreover reports from African series have suggested a pattern of presentation that significantly differs from that of western countries. The purpose of this study is to clarify knowledge of salivary gland tumors in Ethiopia on the light of the experience gained form African and western countries. The study was based on the biopsy material collected in the Department of Pathology, Addis Ababa University (AAU), over a period of ten years from 1990-1999 inclusive. This study confirmed that patterns of salivary gland tumors in Ethiopia closely follow the pattern seen in other African countries. Of all salivary gland tumors, parotid gland accounts for 43.2% submandibular gland for 25% and the rest of all minor salivary glands contribute for 31.9%. Out of 176 tumors, 117 were reported to be benign and 59 were malignant. Plemorphic Adenoma forms 58.5% of all tumors. Since "Variations" are of great interest in the geographical study of diseases, discrepancies observed in the two worlds of Africa and western countries are discussed. We recommend that any future plan should stand from the observed disparity between the two worlds and address the problem through better methodology to draw firm conclusion.     

Distribution of substance P and methionine-enkephalin in salivary glands and effect of chronic morphine treatment on levels of these peptides

Substance P-like immunoreactivity (SPLI) and methionine-enkephalin-like immunoreactivity (MELI) were determined in salivary glands from rats by radioimmunoassay. In all salivary glands investigated (submandibular gland, sublingual gland and parotid gland), SPLI and MELI were detected. The amount of both peptides is comparable to or relatively higher than those found in any other peripheral tissue. The level of SPLI showed a tendency to increase following chronic treatment with morphine: the enhancement in the submandibular gland and the sublingual gland was especially remarkable. The level of MELI was decreased, particularly in the submandibular gland.     

Salivary gland scintigraphy in gastro-esophageal reflux disease

Gastro-esophageal reflux disease (GERD) is associated with a decreased salivary flow as well as gastric acid production. This study therefore aimed to investigate functional disorders of salivary glands in patients with GERD. Methods: Thirty-one consecutive patients with GERD underwent salivary gland scintigraphy. Results: If the results defined the optimal cutoff point for determining the decreased salivary secretion as 51 % in parotid glands and 36 % in submandibular glands, a decreased salivary secretion of right parotid gland, left parotid gland, right submandibular gland, and left submandibular gland was found in 39 %, 32 %, 36 %, and 58 %, respectively. Overall, salivary function disorder of at least one major salivary gland was found in 24 patients (78 %) with GERD. There was no difference in the incidence of impaired salivary function between GERD patients with and without erosive esophagitis. Salivary gland function was more frequently diminished than expected in GERD. We concluded that the presence of impaired salivary gland function was considered to be one of risk factors for developing GERD symptoms. Received 12 July 2006; accepted 10 September 2006     

A study on the distribution of T-3262 (tosufloxacin tosilate) in salivary glands of rats using microautoradiography

The distribution of T-3262 (tosufloxacin tosilate) in salivary glands of rats was investigated with frozen-microautoradiography. One and 4 hours after oral administration of 14C-T-3262 at 100 mg/kg to rats submandibular glands, parotid glands and sublingual glands were removed, and a microautoradiogram of each was made. In the submandibular gland and the parotid gland 14C-T-3262 was distributed at high levels throughout the glands taken at 1 and 4 hours after administration, but lower levels than the other glands were found in the sublingual gland at 1 hour. The results of this study suggested that T-3262 penetrates effectively into the saliva, because 14C-T-3262 is distributed well into glandular acinus, striated duct and excretory duct. The microautoradiography was a useful and reliable method for investigating the distribution of antimicrobial agents in salivary glands.     

Cutaneous leiomyomatosis and parotid pleomorphic adenoma

We present a case of cutaneous leiomyomas (CL) arising in a pleomorphic adenoma (PA) of the parotid gland. PA and CL are benign tumors arising from the parotid gland and the erector pilli muscle, respectively. They both have a benign clinical course and in most cases leiomyomas are multiple in nature. PAs of the parotid are the most frequent benign tumors of the major salivary glands. To our knowledge this is the first case of PA with CL.     

Effects of repeated infusions of substance P and vasoactive intestinal peptide on the weights of salivary glands subjected to atrophying influences in rats.

1. The long-term influence of substance P (SP) and vasoactive intestinal peptide (VIP) on rat salivary gland weight was investigated after parasympathetic denervation or on feeding soft food. 2. The parotid gland lost about one-third of its weight within 4-5 days following parasympathetic post-ganglionic denervation or change in dietary regimen, from pellets to liquid diet, thought to reduce nerve reflex activity. 3. Daily i.v. infusions with SP or VIP diminished or largely prevented the fall in parotid gland weight, whereas infusions with pentagastrin, bethanechol and saline had no effect. The infusions were preceded by administration of alpha- and beta-adrenoceptor antagonists; these antagonists were also given to the control animals. 4. The effect of SP and VIP on the parotid gland weight appeared to be related to cell size rather than to cell number, as judged by measurements of RNA and DNA. 5. Observations on the two other major salivary glands underlined the fact that different gland types in the same animal behave differently. Parasympathetic preganglionic denervation (decentralization) lowered the weights of the sublingual and submandibular glands, whereas liquid diet only reduced the weight of the sublingual gland. SP and VIP did not affect the weights of the submandibular glands, but VIP prevented the slight fall in sublingual gland weight induced by liquid diet. 6. The present results suggest a trophic role in rats for SP and VIP on parotid glands and for VIP on sublingual glands. Such an influence may be exerted naturally as a result of their release from nerves containing these peptides around acini.     

区域性切除腮腺浅叶良性肿瘤的临床研究

目的 探讨腮腺良性肿瘤手术治疗的方法以减少术后并发症。方法 采用区域性切除术治疗腮腺浅叶良性肿瘤首发病例113例，肿瘤直径均〈2．3cm，在距肿瘤边界1．0cm处的正常腺体内切除肿瘤，随访1～7年，观察其并发症的发生率及肿瘤复发情况。结果 全部患者术后面部畸形较轻，腮腺功能良好，暂时性面部不对称占37．17％（42／113），涎漏占4．42％（5／113），Frey＇s综合征占1．77％（2／113），肿瘤复发率为2．65％（3／113）。结论 对于体积较小的腮腺浅叶良性肿瘤采用区域性切除术治疗，可以保存腮腺一定的功能，手术创伤小，并发症少，肿瘤复发率低，可作为腮腺浅叶体积较小的良性肿瘤治疗的首选术式。     

小涎腺肿瘤的诊断与治疗

目的探讨小涎腺肿瘤的诊断与治疗。方法对本院1998～2003年收治的经病理检查确诊的60例小涎腺肿瘤患者的诊断与治疗进行了回顾性分析。结果60例口腔小涎腺肿瘤中,良性肿瘤26例占43.33%,恶性肿瘤34例占56.67%,良性肿瘤中的混合瘤多见,占良性肿瘤的69.23%,恶性肿瘤中以黏液表皮样癌为多,共14例,占恶性肿瘤的41.18%,手术 放疗者占恶性肿瘤的38.24%,5年生存率为34.48%。结论小涎腺肿瘤中恶性肿瘤多于良性肿瘤;术前X线检查和术中冰冻病理检查对诊断和治疗有指导意义;首次手术彻底性是防止复发的关键,术后辅助性放疗可降低恶性肿瘤复发率。