涎腺上皮性肿瘤1282例病理组织学分类及临床资料统计

作者对1282例涎腺上皮性肿瘤的病理组织学分类和临床发病情况进行了统计分析。结果表明,涎腺腺瘤723例,占56.4％;涎腺癌559例,占43.6％。多形性腺瘤居涎腺腺瘤首位,粘液表皮样癌为最常见的涎腺癌。除Warthin瘤男性明显多于女性外,涎腺上皮性肿瘤的性别分布无明显差异;涎腺腺瘤的发病年龄较涎腺癌相对年轻,但差异不显著;涎腺腺瘤多发于大涎腺,涎腺癌多发于小涎腺。     

HER-2基因在涎腺恶性肿瘤中表达及临床意义的研究

目的:分析HER-2的表达与涎腺涎腺恶性肿瘤的淋巴结转移、临床分期、组织学分形及预后差的关系,观察HER-2表达对涎腺涎腺恶性肿瘤预后的影响。方法:应用免疫组化SP法探讨HER-2在39例涎腺涎腺恶性肿瘤中的表达情况,并结合临床表现、病理学指标及随访资料,进一步分析其对涎腺涎腺恶性肿瘤预后的影响。结果:HER-2在涎腺涎腺恶性肿瘤中呈高表达,且和肿瘤的临床分期(P=0.018),组织学分级(P=0.003),淋巴结转移(P=0.002)有关,但与患者的性别(P=0.931)和年龄(P=0.520)无关。HER-2高表达患者的生存率和低表达患者有显著差异(P=0.03)。结论:HER-2癌基因的过度表达与涎腺癌的淋巴结转移、临床分期、组织学分形及预后差有关。该基因表达的检测可用于涎腺癌常规病理检查,作为判断涎腺癌的预后及拟定术后治疗方案的参考依据之一。     

涎腺乳头状囊腺癌的超微结构

涎腺乳头状囊腺癌是涎腺上皮性恶性肿瘤之一。在以往的文献中,它曾被称为恶性乳头状囊腺瘤(malignant papillary cystadenoma),粘液乳头状腺癌(mucus-producing adenopapillary carcinoma)。目前我们所见的国内外文献中,尚未发现对涎腺乳头状囊腺癌进行电镜研究     

癌基因c—erbB—2在涎腺肿瘤中的表达

作者利用抗c-erbB-2单克隆抗体,用免疫组化的方法,对50例涎腺肿瘤(腺癌,涎腺导管癌、粘液表皮样癌、腺样囊性癌、多形性腺瘤各10例)进行癌基因、c-erbB-2的检测。不同种类的涎腺肿瘤,其c-erbB-2的表达很不一致。腺癌及涎腺导管癌的阳性表达率较高,粘液表皮样癌及多形性腺瘤较低,腺样囊性癌为阴性。c-erbB-2的表达与肿瘤分化度有一定关联,涎腺肿瘤组织形态学的多样性,可能与c-erbB-2的表达不同有关。     

涎腺上皮性肿瘤1282例病理组织学分类及临床资料统计

作者对１２８２例涎腺上皮性肿瘤的病理组织学分类和临床发病情况进行了统计分析，结果表明，涎腺腺瘤７２３例，占５６．４％；涎腺癌５５９例，占４３．６％，多形性腺瘤居涎腺腺瘤首位，粘液表皮样癌为最常见的涎腺癌。除Ｗａｒｔｈｉｎ瘤男性明显多于女性外，涎腺上皮肿瘤的性别分布无明显差异，涎腺腺瘤的发病年龄较涎腺癌相对年轻，但差异不显著，涎腺腺瘤多发于大涎腺，涎腺癌多发于小涎腺。     

涎腺癌

涎腺癌周正炎早在１７５２年ＫａＩｔｓｃｈｉｅｄ就已经描写了确诊的涎腺肿瘤，几个世纪来一直无较大进展。Ｋ·ＨＴｈｏｍａ１９６３年在其著名的第四版《口腔外科学》的著作中，将涎腺肿瘤归纳到涎腺疾病章内。１９８０年上海第二医科大学主编的《口腔颌面外科学》也将...     

EphA2在涎腺肿瘤中的表达及其临床意义

目的检测EphA2在涎腺肿瘤中的表达，并分析其临床病理意义。方法免疫组化S-P法检测10例正常涎腺组织、30例多形性腺瘤、30例黏液表皮样癌（MEC）、30例腺样囊性癌（ACC）中EphA2的表达。分析EphA2表达与患者的年龄、性别、肿瘤部位、大小、TNM分期以及复发、淋巴结转移等临床病理因素的关系。比较EphA2在正常涎腺组织及几种常见的涎腺良、恶性肿瘤中的表达差异。结果EphA2在正常涎腺组织中主要表达于腺管上皮，而腺泡细胞几乎不表达。EphA2在正常涎腺组织、多形性腺瘤、涎腺癌（包括黏液表皮样癌和腺样囊性癌2组）中的表达依次增高，存在显著性差异（P〈0．05）。EphA2的表达与涎腺癌瘤体大小、TNM分期、复发和淋巴结转移有关（P〈0．05）。结论EphA2可能影响涎腺肿瘤发生、发展及其预后。     

增殖细胞核抗原在涎腺腺癌中的表达及其临床意义

目的探讨增殖细胞核抗原(PCNA)在涎腺腺癌中的表达及临床意义。方法选择47例涎腺腺癌石蜡标本,用免疫组化方法(SABC)测定PCNA表达。结果PCNA在涎腺腺癌中的表达阳性率为(76.12±19.24)%,表达呈异质性。PCNA指数与口腔癌的肿瘤大小、分化程度、淋巴结转移相关,与TNM分期无关。结论PCNA可作为判断涎腺腺癌恶性程度及预后的有效指标。     

大涎腺上皮性肿瘤212例临床分析

目的 总结大涎腺上皮性肿瘤的临床特点,指导临床实践。方法 按照WHO 1991年涎腺肿瘤组织学分类标准,对212例经病理确诊的大涎腺上皮性肿瘤进行回顾性临床分析,讨论良、恶性肿瘤的不同临床特征。结果 212例肿瘤中,腺瘤166例(78.3％),以多形性腺瘤为主;涎腺癌46例(21.7％),以腺样囊性癌最多见。腮腺是最主要发病部位。涎腺腺瘤临床多表现为无痛性肿块,涎腺癌常伴有疼痛和(或)神经麻痹等症状。结论 大涎腺良、恶性肿瘤具有不同的临床特征,有助于临床正确诊断。     

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。     

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.     

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。     

A clinico-pathologic study of 311 intra-oral salivary gland tumors in Thais

Background:  There have been several epidemiologic studies on intra-oral salivary gland tumors in several countries, but little is known of these tumors in Thailand.
Objectives:  To determine the relative frequency and distribution of various types of intra-oral salivary gland tumors in the Thai population.
Methods:  The files of the Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, from 1969 to 2007 were searched for intra-oral salivary gland tumors. Histopathologic slides were reviewed and reclassified according to the 2005 WHO Classification of Head and Neck Tumors. The age, gender, race, and anatomical distribution of the tumors were collected from the patients' records.
Results:  Of the 16,358 accessioned cases, 311 cases (1.90%) were diagnosed as intra-oral salivary gland tumors. One hundred and forty-seven cases (47.27%) were benign tumors, while 164 cases (52.73%) were malignant tumors. The mean age of the patient ± SD = 41.57 ± 16.65 years. Females outnumbered male patients by a ratio of M:F = 1:1.38. Almost all except one patient were Thais. Pleomorphic adenoma was the most common intra-oral salivary gland tumor. The majority of cases occurred at the palate.
Conclusions:  Pleomorphic adenoma is the most common intra-oral salivary gland tumor and the most common benign intra-oral salivary gland tumor, while mucoepidermoid carcinoma is the most common malignant intra-oral salivary gland tumor. Intra-oral salivary gland tumors in Thailand elicit similar trend as in previous studies, with only minor differences such as the ranking of some tumors, the higher incidence of intra-bony location, and the lower incidence of polymorphous low-grade adenocarcinoma.     

Evaluation of the nucleolar organizer region associated proteins in minor salivary gland tumors

Forty-three intraoral salivary gland tumors were studied to determine the value of the AgNOR technique in the assessment of these neoplasms. Well defined black dots were visible in the nucleii of all the specimens studied. The mean AgNOR count per nucleus for each tumor was calculated as follows: pleomorphic adenoma (n = 15) 1.52; Polymorphous low-grade adenocarcinoma (n = 12) 1.90; adenoid cystic carcinoma (n = 6) 2.92; mucoepidermoid carcinoma (n = 4) 1.93; carcinoma ex mixed tumor (n = 4) 2.05; undifferentiated carcinoma (n = 1) 3.13 and epithelial-myoepithelial carcinoma (n = 1) 2.23. The difference between the means of benign and malignant tumors (P less than 0.01) and polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma (P less than 0.01) were highly significant. The overlapping of the AgNOR count between various tumors prohibited the use of this technique as an absolute criterion in establishing a final diagnosis. It could however be used as a diagnostic aid in differentiating between salivary gland neoplasms.     

Hyposalivation in a 16‐year‐old girl: a case of salivary gland aplasia

Salivary gland aplasia is a rare condition with only a small number of cases reported worldwide. It is more commonly seen in males and can occur either in isolation or association with other defects or syndromes. It may or may not occur with a hereditary background. Scant literature exists detailing the status of sublingual salivary glands in patients with any form of major salivary gland aplasia. This case report describes the clinical and magnetic resonance imaging presentation of a 16‐year‐old girl with major salivary gland aplasia detailing the status of all six major salivary glands.     

骨桥蛋白在涎腺良、恶性肿瘤中的表达及意义的研究

目的 探讨骨桥蛋白(OPN)在涎腺良、恶性肿瘤中的表达及意义。方法 采用免疫组化SP法检测OPN在68例涎腺肿瘤(多形性腺瘤20例、腺样囊性癌24例、Warthin瘤24例)和20例瘤旁正常涎腺组织中的表达。结果 OPN在多形性腺瘤和Warthin瘤中均较正常涎腺组织增高(P<0.05);在腺样囊性癌中较正常涎腺组织增高,但两组间比较差异无显著性(P>0.05)。结论 OPN在正常涎腺组织和腺样囊性癌中有弱表达,在多形性腺瘤和Warthin瘤中表达增高。     

Hyaluronan and CD44 expression in minor salivary gland tumors

OBJECTIVES: Hyaluronan (HA) and CD44 are most likely associated with tumor invasion and metastasis. Malignancies with different degrees of aggressiveness may express different levels and patterns of HA and CD44. The aim of this project was to examine the distribution of HA and CD44 in minor salivary gland tumors to determine if staining could be correlated with biologic behavior or tumor type. MATERIALS AND METHODS: Biotinylated hyaluronan binding protein as a probe for HA and monoclonal antibodies specific for CD44 were used to stain classic examples of the five most commonly encountered minor salivary gland tumors: monomorphic adenomas, pleomorphic adenomas, polymorphous low grade adenocarcinomas, mucoepidermoid carcinomas, and adenoid cystic carcinomas. RESULTS: Tumor cells of monomorphic adenomas were negative for both HA and CD44, and tumor capsules were intensely HA-positive. Pleomorphic adenomas exhibited HA and CD44 positivity in both mesenchymal and epithelial components, and HA in capsular tissues. All malignant salivary gland tumors expressed similar intense HA in tumor stroma. HA staining was more intense in stroma than in parenchymal cells. Tumor cells of most adenoid cystic carcinomas were HA-positive, while most polymorphous low grade adenocarcinomas were HA-negative. HA was uniformly distributed throughout supporting stroma of high and low grade malignancies, except for two polymorphous low grade adenocarcinomas (PLGAs) in which HA was more intense at the invading edge of the tumors. CD44 expression was seen only in tumor cells (not stroma) of malignancies, and was of similar intensity in both low and high grade tumors. CONCLUSIONS: Differences in the expression of HA and CD44 among different types of salivary gland tumors were noted. These findings, however, could not be correlated with known biologic behaviors of the tumor groups studied. Immunohistochemical staining of salivary gland tumors for HA and CD44 may be useful in separating monomorphic adenoma, polymorphous low grade adenocarcinoma and adenoid cystic carcinoma, lesions that may be difficult to distinguish with routine light microscopy.     

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.     

Low-grade adenocarcinoma of the oral cavity: polymorphous or papillary?

Polymorphous low-grade adenocarcinomas are low-grade malignant salivary-gland neoplasms with a broad variety of architectural patterns. Whether papillary structures fall within this spectrum or whether they should lead to a diagnosis of papillary low-grade adenocarcinoma is a subject of debate. This problem was investigated by analyzing a series of 22 salivary gland neoplasms. It was concluded that papillary structures form part of the histologic spectrum of polymorphous low-grade adenocarcinoma but that there are also tumors with papillary structures as a single component. In most instances these are more properly classified as papillary cystadenocarcinomas. As the designation papillary low-grade adenocarcinoma has been used for polymorphous low-grade adenocarcinomas with papillary structures as well as for papillary cystadenocarcinoma, it is advocated that the diagnosis of papillary low-grade adenocarcinoma should be discontinued.     

Salivary gland tumours: immunoexpression of integrins β1, β3 and β4

BACKGROUND: Integrins, heterodimeric transmembranic adhesion molecules composed of alpha and beta subunits, have been implicated in normal and neoplastic biological processes. We investigated the patterns of expression of integrins subunits beta 1, beta 3 and beta 4 in neoplasms derived from the terminal segment of salivary glands in order to understand their expression patterns in the different structures of these tumours. METHODS: Immunohistochemistry using 'catalized signal amplification' (CSA) detection system was applied to paraffin-embedded specimens of polymorphous low-grade adenocarcinoma, adenoid cystic carcinoma and acinic cell carcinoma. Normal salivary glands were used as controls. RESULTS: Immunoexpression of integrins showed that neoplastic structures of the tumours studied tend to mimic the patterns seen in the normal structures of salivary glands from which they are derived. Anaplastic cells were negative for all integrins. CONCLUSIONS: This study revealed detailed topography of integrins in malignant tumours derived from intercalated acinar segment of salivary gland and this might be useful in the diagnosis of these lesions, especially of fine-needle aspiration (FNA) products or small specimens derived form incisional biopsies.