涎腺腺瘤和腺癌的核仁组成区银染色研究

应用银染色法对50例涎腺肿瘤核仁组成区相关蛋白进行定性定量研究。查见核仁组成区银颗粒在正常涎腺,良、恶性腺瘤三组中,逐级增多,各组间有显著差异。粘液表皮样癌的银粒数也逐级增多,Ⅲ级(高恶)与Ⅰ、Ⅱ级间的差异显著。结果显示AgNOR对鉴别涎腺良、恶性肿瘤是一项值得重视的新指标;也有助于粘液表皮样癌的分级。此外还提出,对嗜银颗粒,除总粒计数法之外,用簇或簇粒计数建立方法也是可取的。     

桩蛋白在涎腺黏液表皮样癌中的表达

目的:探讨桩蛋白(paxillin)在涎腺黏液表皮样癌中表达的意义。方法:采用HE染色方法筛选典型病例与免疫组织化学方法分析21例黏液表皮样癌中paxillin的表达。结果:paxillin在正常涎腺组织的基底膜、腺管部位有弱阳性表达,在黏液表皮样癌中有强阳性表达,其强弱程度与病理分级存在相关性(r=0.75,P<0.01),染色强度与染色面积评分之和与病理分级存在相关性(r=0.93,P<0.01),在肿瘤浸润前沿表达显著。结论:在涎腺黏液表皮样癌中paxillin表达强弱程度与病理分级密切联系,癌症浸润前沿表达情况可以为临床治疗提供参考。     

组织蛋白酶D在涎腺黏液表皮样癌中的表达

目的探讨组织蛋白酶D(Cath-D)在涎腺黏液表皮样癌中表达的意义。方法采用苏木素-伊红染色方法筛选典型病例与免疫组织化学方法分析21例黏液表皮样癌中Cath-D的表达。结果 Cath-D在正常涎腺组织的基底膜、腺管部位有弱阳性表达,在黏液表皮样癌中有强阳性表达,其强弱程度与病理分级存在相关性(r=0.54,P<0.01)。染色强度与染色面积评分之和与病理分级存在相关性(r=0.66,P<0.01)。在肿瘤浸润前沿表达显著。结论在涎腺黏液表皮样癌中Cath-D表达强弱程度与病理分级密切联系,癌症浸润前沿表达情况可以为临床治疗提供参考。     

Warthin样黏液表皮样癌、Warthin瘤合并黏液表皮样癌及伴黏液化生3例

Warthin样黏液表皮样癌是一种新近发现的涎腺黏液表皮样癌亚型,形态类似于Warthin瘤,但具有与黏液表皮样癌相似的t(11;19)(q21;p13)染色体易位.因此鉴别诊断非常重要.Warthin瘤合并黏液表皮样癌极为罕见.本文报告了1例Warthin样黏液表皮样癌、1例Warthin瘤合并黏液表皮样癌、1例Wa...     

癌细胞形态测量和DNA定量分析对涎腺癌分类诊断的价值

用图象分析技术测量29例涎腺癌细胞核形态参数和DNA含量。综合核形态和DNA测量结果进行多元判别分析，对涎腺癌作出分类、诊断，总符合率为82.8%，其中高分化粘液表皮样癌100%、腺样囊性癌85.7%、腺癌83.3%、中低分化粘液表皮样癌75%、恶性混合瘤和乳头状囊腺癌均为66.7%。认为核形态测量和DNA定量分析可人微言轻涎腺癌病理诊断的重要辅助手术。     

XIAP在涎腺黏液表皮样癌中的表达及意义

目的检测X染色体连锁凋亡抑制蛋白(x-linked inhibitor of apoptosis protein,XIAP)在涎腺黏液表皮样癌(mucoepidermoid carcinoma,MEC)中的表达,探讨XIAP的表达在涎腺黏液表皮样癌发生发展中的作用。方法采用免疫组织化学法检测25例涎腺黏液表皮样癌中XIAP的表达,分析其与临床病例的关系。结果 XIAP在MEC中呈高表达,在正常涎腺组织中不表达或低表达;MEC和正常涎腺组织XIAP阳性检出率分别为84%(21/25)和0.00%(0/10)(P<0.01);XIAP表达与MEC组织病理分化程度呈正相关关系(P<0.05),而与肿瘤部位、临床分期、远处转移无相关性(P>0.05)。结论 XIAP在MEC中高表达,可能在MEC发生过程中具有重要的作用。     

涎腺粘液表皮样癌中的核仁组织导体区研究

采用 AgNOR 技术及电镜技术对不同分化程度的粘液表皮样癌中的核仁组织导体区(NORs)的数目、大小及分布特征进行了观察。结果表明:在光镜下,高分化肿瘤细胞核内具有少数较大的 NORs,分布较集中,而低分化肿瘤中 NORs 数目增多且较小,其分布趋于更加散在,中分化肿瘤中 NORs 变化的特点则介于前两者之间。在超微结构水平上,随着肿瘤恶性程度的增加,核仁内纤丝中心变小且数量增多。因此,作者认为,AgNOR 技术在涎腺粘液表皮样癌的组织学分级判断中具有一定的应用价值。     

影响涎腺粘液表皮样癌术后复发的临床病理因素分析

目的 探讨影响涎腺粘液表皮样癌病人术后复发的临床病理因素。方法 回顾经本院手术并获得五年以上随访或不足五年而出现复发的涎腺粘波表皮样癌77例，对各项临床病理指标进行单因素似然比检验及多因素Logistic回归分析，资料的统计学处理全部通过SPSS软件完成。结果 本组涎腺粘液表皮样癌术后复发有其自身的特点。在单因素分析中，性别、分化程度、原发灶的处理方式、小涎腺粘液表皮样癌侵犯骨的处理等因素均与术后复发相关。性别、分化程度、原发灶的处理方式做为影响术后复发的主要因素进入Logistic回归方程，所得回归方程对术后复发的分类能力可达84．4％。结论 性别、分化程度、原发灶的处理方式是影响涎腺粘液表皮样癌术后复发的主要因素。     

黏液表皮样癌中CEACAM5和CEACAM6的表达及意义

目的检测癌胚抗原相关细胞黏附分子5(CEACAM5)和癌胚抗原相关细胞黏附分子6(CEACAM6)在涎腺黏液表皮样癌(MEC)组织中的表达情况,分析二者与涎腺黏液表皮样癌发生发展的关系。方法 60例黏液表皮样癌标本,以30例癌旁正常涎腺组织作对照,通过免疫组化法分别检测CEACAM5和CEACAM6在标本中的表达情况。结果 MEC组中CEACAM5和CEACAM6的蛋白阳性表达率分别为(68.3%,65%),明显高于正常涎腺组织中的表达率(40%,36.7%)(P<0.05),MEC组中CEACAM5和CEACAM6蛋白的阳性表达与MEC的分化程度、临床分期及颈部淋巴结转移密切相关(P<0.05),与患者的性别和年龄无关(P>0.05)。CEACAM5和CEACAM6在MEC组织中的阳性表达呈正相关。结论 CEACAM5和CEACAM6在黏液表皮样癌组织中的异常表达促进肿瘤的发生,均参与肿瘤的进展,联合检测可能与患者的预后密切相关。     

涎腺疾病

水通道蛋白-1，5在干燥综合征小鼠下颌下腺中的表达;：17β-雌二醇对涎腺黏液表皮样癌高转移细胞Mc3黏附、侵袭和移动力的影响;治疗角结膜干燥症自体颌下腺移植的血管处理;雌二醇对人涎腺腺样囊性癌细胞增殖和转移作用的研究;异丙肾上腺素对SD大鼠原代颌下腺细胞增殖的影响     

Ultrastructural study of the histogenesis of salivary gland mucoepidermoid carcinoma

This electronmicroscope study of the histogenesis of mucoepidermoid carcinoma is based on 15 cases from the major and minor salivary glands. Six major cell types were identified: undifferentiated (cuboid) stem cells, intermediate (columnar) cells, serous/mucoid secretory cells, mucus-producing goblet cells, squamous/epidermoid cells and myoepithelium. It is proposed that undifferentiated stem cells serve as pluripotential reserves which give rise to the various cell types seen in mucoepidermoid carcinoma. Reserve cells in the acinar-intercalated duct components of the salivary glands appeared to give rise to the serous/mucoid and myoepithelial cell populations of mucoepidermoid carcinoma. Reserve cells in the proximal ducts system (intra/extralobular striated ducts and excretory ducts) differentiated into myoepithelium, intermediate (columnar) cells, squamous/epidermoid and mucus-producing goblet cell lines. It is proposed that neoplastic reserve cells give rise to different tumor types in the salivary glands. These types result from varying admixtures and arrangements of tumor cells at different stages of their structural and functional cytodifferentiation from reserve cells. It is further proposed that neoplastic reserve cells differentiate along similar cell lines as the embryonic "stem cells" in the development of normal salivary glands.     

Dnmt1和Dnmt3b在唾液腺黏液表皮样癌中的表达及意义

目的： 探讨DNA 甲基转移酶（DNA methyltransferase, Dnmt）在唾液腺黏液表皮样癌（mucoepidermoid carcinoma,MEC）中的表达及意义。方法： 选取2010 年1 月—2013 年9 月间中国医科大学附属盛京医院口腔颌面外科手术切除的唾液腺术后的标本43例,正常唾液腺组织17例,应用免疫组织化学和蛋白免疫印迹（Western blot）方法检测正常组织及MEC组织中Dnmt1和Dnmt3b 的表达。采用SPSS22.0软件包对数据进行统计学分析。结果： Dnmt1在MEC组织中的阳性表达率为37.21%,与正常唾液腺组织的17.65%相比,差异无显著性（P>0.05）;Dnmt3b在MEC组织中的阳性表达率为83.72%,显著高于正常唾液腺组织的11.76%（P<0.01）;但两者的高表达与临床病理参数之间无显著相关性（P>0.05）。结论： Dnmt3b在唾液腺MEC 的发生中可能发挥一定作用。     

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％。     

Nucleolar organizer regions (NORs) evaluation of lingual salivary glands of chronic alcoholics

BACKGROUND: Chronic alcoholism has been associated with structural and physiological changes in salivary glands. Studies on a variety of pathologies have suggested that variation in number of nucleolar organizer regions (NORs) reveals conditions of cellular activity. The aim of this work was to examine, through the AgNOR technique, changes in number and size of NORs in lingual salivary glands of chronic alcoholics. METHODS: Samples of mucous and serous lingual salivary glands were obtained from tongues from autopsies of individuals whose cause of death was hepatic alcoholic cirrhosis. Lingual organs from individuals whose cause of death was accidental were used as controls. Number and size of the AgNORs and nuclear area, in ductal and acinar cells, were evaluated through a digital image analyzer. RESULTS: Statistical analysis revealed differences (P < or = 0.05) in number of AgNORs in mucous acini and ductal cells. Also, we observed changes in the area of the NORs. CONCLUSION: These results suggest that in alcoholics the activity of glandular cells, mainly in ductal epithelium, could be affected, modifying synthesis, transport and salivary secretions.     

唾液腺黏液表皮样癌组织中分化抑制因子-1和血小板反应蛋白-1的表达

目的探讨不同恶性程度的唾液腺黏液表皮样癌组织中分化抑制因子- 1（Id- 1）、血小板反应蛋白- 1（TSP- 1）的表达情况及相互关系。方法以不同恶性程度的唾液腺黏液表皮样癌和正常唾液腺组织为材料,采用免疫组化SP法检测正常唾液腺组织以及高分化、中分化和低分化黏液表皮样癌组织中Id- 1、TSP- 1基因的表达情况。结果Id- 1和TSP- 1在正常唾液腺中的阳性表达率明显低于在黏液表皮样癌组织中的阳性表达率（P值分别为0.000和0.013）。在中分化和低分化黏液表皮样癌组织中Id- 1的蛋白表达率明显高于高分化黏液表皮样癌（P值分别为0.001和0.002）,而Id- 1在中分化和低分化黏液表皮样癌组织中的蛋白表达率差异无统计学意义（P>0.05）。在低分化黏液表皮样癌组织中TSP- 1的蛋白表达率明显低于高分化黏液表皮样癌（P=0.014）,而TSP- 1在中分化和低分化黏液表皮样癌组织中的蛋白表达率差异无统计学意义（P>0.05）,在中分化和高分化黏液表皮样癌组织中的蛋白表达率差异无统计学意义（P>0.05）。TSP- 1的表达与Id- 1呈负相关（r=- 0.394,P=0.002）。结论TSP- 1的表达可能抑制黏液表皮样癌的发生,而Id- 1的表达则可能促进黏液表皮样癌的发生,二者之间呈负相关。     

Sclerosing mucoepidermoid carcinoma of the oral cavity

Sclerosing mucoepidermoid carcinoma (SMEC) with eosinophilia is a rare but distinctive tumor usually affecting the thyroid. SMEC involvement of salivary gland is exceptional, with only six cases in the literature. We present here the first case of an intermediate-grade SMEC, arising from the intraoral minor salivary glands. A particularly interesting finding is the cytoplasmic accumulation of eosinophilic hyaline granules in carcinoma cells, similar to aberrant zymogen-like granules previously described in salivary sclerosing polycystic adenosis.     

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.     

影响唾液腺粘液表皮样癌患者术后生存的临床病理因素分析

目的　探讨影响唾液腺粘液表皮样癌患者术后生存的临床病理因素。方法　回顾经首次手术治疗且有完整随访资料的唾液腺粘液表皮样癌患者 70例的临床资料 ,对各项指标采用乘积限法 (Kaplan-Meier)估计各时点的生存率 ,同时进行序检验 (Logranktest)各组间差异 ,最后进入Cox比例风险模型 (CoxRegression)做多因素分析。全部资料通过SPSS软件完成。结果　 70例唾液腺粘液表皮样癌患者 ,术后 3、5、1 0年生存率分别为 90 6 6 %、88 85 %、86 6 3%。肿瘤直径小于等于 4cm、术前区域淋巴结无转移、临床处于早期 (Ⅰ、Ⅱ期 )、高分化、术后无复发和转移的患者生存期明显长于肿瘤直径大于 4cm、术前区域淋巴结有转移、临床晚期 (Ⅲ、Ⅳ期 )、低分化、术后出现复发及转移的患者。结论　TNM分类、临床分期、分化程度以及术后有无复发和转移是影响唾液腺粘液表皮样癌患者术后生存的重要因素.     

Ultrastructure of mucoepidermoid carcinoma in minor salivary glands.

Three cases of mucoepidermoid carcinoma of minor salivary glands were studied by electron microscopy. Mucus-secreting cells contained numerous mucous globules and bundles of fine cytoplasmic filaments. Another cell type contained a large number of glycogen particles, akin to tumor cells in glycogen-rich adenocarcinoma, and it is postulated that these cells represent the intermediate cells observed by light microscopy. Epidermoid cells contained a moderate amount of tonofilaments and various numbers of organelles. Mucus-secreting and epidermoid cells that surrounded a cystic space exhibited many microvilli. Results of this study support the theory that mucoepidermoid carcinoma develops from salivary gland duct cells with different cellular differentiation potentials and, in general, agree with the conventional grading system of mucoepidermoid carcinoma.