涎腺肿瘤中Pax9基因的表达及其意义

目的:检测正常涎腺组织及涎腺肿瘤中转录因子Pax9的表达。方法:采用免疫组化SABC法,研究Pax9在正常涎腺组织、多形性腺瘤、腺淋巴瘤、基底细胞腺瘤、粘液表皮样癌和腺样囊性癌共48例中的表达情况。结果:除1例多形性腺瘤外,其余组织均表达Pax9。正常涎腺的腺泡细胞和导管内衬细胞、多形性腺瘤的上皮细胞、腺淋巴瘤的肿瘤上皮细胞和基底细胞腺瘤中Pax9弱阳性表达,差异没有显著性;而在增殖活跃的细胞如正常涎腺导管的基底细胞和恶性肿瘤细胞(粘液表皮样癌、腺样囊性癌)中表达增强,恶性肿瘤中Pax9的强阳性表达率明显增高,与正常和良性肿瘤相比具有显著差异(P<0.05)。结论:Pax9在涎腺肿瘤尤其是恶性肿瘤的发生过程中发挥重要的作用。     

涎腺小管腺瘤的免疫组织化学分析

小管腺瘤是一种良性涎腺肿瘤,好发于老年人,上唇多见;曾被认为是基底细胞腺瘤的一个亚(?),但最近WHO将其列为涎腺肿瘤中单独的一型。它常和某些涎腺肿瘤如腺样囊性癌,腺癌等相混淆。本文目的是研究分析涎腺小管腺瘤的免疫组织化学特征。 材料和方法 6例小管腺瘤患者。男3例,女3例;5例位于上唇,1例位于颊粘膜,年龄54～73岁。为进     

涎腺正常与肿瘤组织中p63、CK5、CK19、CEA及SmA的表达

目的:探索涎腺正常导管、腺泡及其上皮性肿瘤的组织起源.方法:采用免疫组化(二步法)检测正常涎腺组织14 例、多形性腺瘤14 例、基底细胞腺瘤8 例、腺样囊性癌18 例、黏液表皮样癌9 例、低分化腺癌2 例及腺泡细胞癌、乳头状腺癌、恶性多形性腺瘤、肌上皮癌各1 例中p63、CK5、CK19、CEA及SmA的表达.结果:正常涎腺基底细胞与肌上皮细胞层表达CK5,其中部分细胞表达p63,导管部分基底细胞也呈CK19阳性.多形性腺瘤、基底细胞腺瘤、腺样囊性癌与黏液表皮样癌具p63、CK5及CK19高阳性率, SmA阳性率分别为85.71%、1.25%、61.11%、0.00%.CEA阳性细胞见于11.11%腺样囊性癌与55.56%黏液表皮样癌.结论:正常涎腺导管和腺泡的腺上皮及涎腺上皮性肿瘤可能来源于导管、腺泡基底层内呈p63和CK5阳性细胞中的干细胞.     

正常大鼠涎腺组织细胞增殖能力的观察

为了证明正常涎腺细胞增殖能力与肿瘤组织发生的关系，作者用ＢｒｄＵ核标记，ＡＢＣ免疫组化显示，对健康成年大鼠涎腺细胞的增殖能力进行了动态观察和分析，表明：腺泡细胞、闰管细胞和纹管细胞均有不同程度的自我复制能力。标记率的动态观察发现，闰管细胞的即时标记率虽很低，但增长速度很快，５天内最高可增长７８倍，但下降也快，这符合一般干细胞增殖规律，支持了Ｅｖｅｒｓｏｌｅ和Ｂａｔｓａｋｉｓ等提出的关于涎腺组织发生的半多能双储备（干）细胞理论，而本研究又证明腺泡和纹管细胞也存在着一定的自我复制能力，可作为上述理论的补充     

涎腺膜性基底细胞腺瘤的临床病理研究

目的 探讨涎腺膜性基底细胞瘤的临床病理特点及生物学行为。方法 对１２例患者进行临床病理分析。结果 肿瘤由大小及形态不一的上皮团块所组成,团块外周细胞呈栅栏状排列,由玻璃样变的基底膜样物质围绕。４例伴头皮皮肤圆柱瘤,８例为多灶性肿瘤,１例恶变伴颈淋巴结转移。结论 诊断时应注意与实性型基底细胞腺瘤、基底细胞腺癌、实性型腺样囊性癌以及基底样鳞状细胞癌相鉴别。治疗应作全腮腺切除,并严密随访。     

组织蛋白酶D在涎腺肿瘤中的表达

为探讨组织蛋白酶Ｄ在涎腺肿瘤中的表达及意义 ,我们对 10 8例涎腺肿瘤中组织蛋白酶Ｄ的表达进行了分析。材料与方法 :涎腺肿瘤标本 10 8例 ,其中粘液表皮样癌40例 ,腺样囊性癌 2 2例 ,腺癌 8例 ,乳头状腺癌 6例 ,肌上皮癌 5例 ,基底细胞腺癌、上皮肌上皮癌和腺泡细胞癌各 4例 ,导管癌 3例 ,恶性多形性腺瘤 2例 ,多形性低度恶性腺癌1例 ,基底细胞腺瘤 7例 ,肌上皮瘤、混合瘤各 1例。采用常规链亲和素三步法进行免疫组织化学染色。设阴性对照并根据染色范围和强度将其分为 (- )、( )、( )和 ( )4个级别。结果 :阳性染色见于涎腺肿瘤…     

2489例涎腺上皮性肿瘤临床病理分析

目的:了解涎腺上皮性肿瘤的临床病理特点。方法:对2489例涎腺上皮性肿瘤临床病理资料进行统计分析。结果:涎腺恶性上皮性肿瘤840例,腺样囊性癌、黏液表皮样癌、癌在多形性腺瘤中居其前3位;涎腺良性上皮性肿瘤1649例,多形性腺瘤、Warthin瘤、基底细胞腺瘤居其前3位。涎腺恶性、良性上皮性肿瘤男女之比为1.13∶1和0.99∶1;平均发病年龄47.86岁和44.86岁;腮腺和腭部为好发部位。结论:腺样囊性癌和多形性腺瘤是最常见的涎腺恶性、良性上皮性肿瘤。     

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     

36例涎腺多形性腺瘤的免疫组化研究

用S-100蛋白、波形蛋白和角蛋白三种抗体对36例涎腺多形性腺瘤进行免疫组化研究。结果发现:腺管样结构的内衬细胞与鳞化上皮和角化珠呈角蛋白阳性:部分腺管的外层瘤细胞和实性区的变异肌上皮细胞呈S-100蛋白、波形蛋白和角蛋白阳性;粘液样区和软骨样区呈S-100蛋白和波形蛋白阳性,偶尔呈角蛋白阳性。实验表明:涎腺多形性腺瘤的发生可能同纹管与排泄管的基底细胞有关。     

P63蛋白在人胚涎腺发育中的表达及意义

目的探讨P63蛋白在涎腺上皮干细胞发育中的作用及干细胞存在的可能位置。方法收集不同发育阶段的合法流产人胚24例、正常涎腺组织标本10例,对切片行常规HE染色和免疫组织化学SP法染色。结果组织切片见涎腺发育从早期上皮芽增生分支形成树枝状上皮条索,然后形成管腔,最终分支末端细胞增生膨大分化为导管、肌上皮和腺泡细胞。P63的表达从胚胎早期上皮芽中的广泛阳性表达到阳性细胞逐渐减少,呈现区域化散在分布特征,正常成人涎腺中阳性表达细胞仅少量存在于闰管、分泌管、排泄管管壁基底侧。结论P63在维系涎腺上皮性干细胞的生存和分化状态中可能具有重要作用,正常成人涎腺上皮性干细胞仅少量存在于导管管壁基底侧。     

A review of the proliferative capacity of major salivary glands and the relationship to current concepts of neoplasia in salivary glands

The classification of salivary gland tumors relies heavily on histogenetic postulates. One of these, the semipluripotential reserve cell theory, suggests that certain reserve cells in specific segments of the duct system of major and minor salivary glands are critical to the development of neoplasms in these glands. However, direct evidence in support of this hypothesis is unavailable. This survey of proliferative capacity in normal salivary gland is based on a review of data in the literature, our observations of DNA synthetic and mitotic activity in developing rat and human salivary gland, and autoradiographic studies of induced cell proliferation in rat salivary gland. Autoradiography of neonatal rat salivary gland after tritiated thymidine administration, and electron microscopy of these tissues, reveals that as well as duct basal cells, luminal cells at all levels of the duct system and even acinar cells are capable of DNA synthesis and mitosis. Indeed, in such studies, more luminal than basal cells are seen in mitosis. In adult rat salivary gland induced to undergo hyperplasia, more acinar cells than intercalated duct cells are in the S phase of the cell cycle. However, cycling cells were observed even in striated ducts and, importantly, both basal and luminal cells of major interlobular excretory ducts are also labeled. Similar findings are present in fetal and adult human salivary glands. From such observations, it is evident that dividing cells are not limited to basal cells of excretory ducts and luminal cells of intercalated ducts, so that there is no support for the semipluripotential bicellular reserve cell hypothesis. However, there is considerable evidence for a multicellular theory of tumor histogenesis; that is, any of the multiplicity of cell types in normal salivary gland have the potential to give use to any of the various types of tumor occurring in this organ.     

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.     

Immunohistochemistry and ultrastructure of myoepithelium and modified myoepithelium of the ducts of human major salivary glands: histogenetic implications for salivary gland tumors

The organization of salivary gland ducts, especially the presence or absence of myoepithelial cells, is central to histogenetic approaches to the classification of salivary gland tumors. Striated and excretory ducts are reported to be devoid of myoepithelial cells but do contain basal cells. To investigate the nature of such basal cells, tissue sections of normal human salivary glands were examined by means of immunohistochemical, ultrastructural, and fluorescent microscopic techniques. With the use of a mouse monoclonal anticytokeratin antibody (3 12C8-1) that, in salivary glands, is specific for myoepithelial cells, these cells associated with acini and intercalated ducts were strongly stained, as were the basal cells of striated and excretory ducts in each case. Ultrastructurally, some basal cells of both striated and excretory ducts had narrow, elongated cellular processes or the main portion of the cell containing parallel arrays of microfilaments with linear densities and micropinocytotic vesicles, whereas in other basal cells tonofilament bundles predominated. A similar range of cytoplasmic features existed in myoepithelial cells associated with acinar and intercalated duct cells. In addition, some duct basal cells have a complement of actin filaments similar to classic myoepithelium of acini and intercalated ducts. Striated and excretory ducts of human salivary glands, therefore, contain fully differentiated and modified myoepithelial cells, both of which express a specific cytokeratin polypeptide that is absent from duct luminal and acinar cells. Differentiation patterns in the intralobular and interlobular ducts suggest that these regions of salivary gland parenchyma cannot be excluded as histogenetic sites for the induction of salivary gland tumors in which neoplastic myoepithelial cells have been shown to have a major role.     

Immunohistological study of the epithelial components of Warthin's tumor

In order to gain insight into the origin of Warthin's tumor, 10 cases of Warthin's tumor were compared immunohistologically with macroscopically and microscopically normal areas of the same glands, using 6 types of functional markers; carcinoembryonic antigen, secretory component, lactoferrin, keratin, S-100 protein and glial fibrillary acidic protein. It was shown that in normal parotid glands, the cells of acini, the intercalated ducts, the striated ducts, and the excretory ducts, as well as myoepithelial cells differed from each other in intensity and distribution of reaction products with antisera against those markers. Although the differences were rather subtle, the results suggested that those markers could differentiate the cell types of the salivary glands. In Warthin's tumors with double-layered tumor epithelia, the staining characteristics of the luminal and basal epithelia differed from each other. Epithelial cells on the luminal side showed immunological characteristics similar to striated duct cells of the parotid gland, while those of the basal side had characteristics similar to those of basal cells of the excretory duct. It is therefore suggested that the epithelia of Warthin's tumor may show differentiation into 2 different cell types.     

层粘蛋白在涎腺多形性腺瘤的表达和分布

本文报道２５例涎腺多形性腺癌中层粘蛋白（Ｌａｍｉｎｉｎ）的免疫组织化学分析。在非肿瘤涎腺组织中，层粘蛋白免疫染色见于排泄管的基底细胞和管壁细胞、闰管细胞及腺泡细胞；腺泡周围的基底膜染色阳性；但正常肌上皮细胞对层粘蛋白无反应。在多形性腺瘤中，层粘蛋白的表达呈点滴一颗粒状，分布于肿瘤腺管——囊腔结构处上在细胞的邻接面和管腔面。在玻璃样间质中，层粘蛋白免疫染色阳性见于细胞区与玻璃间质的边缘。各种变异的肌上皮细胞呈层粘蛋白阳性。根据研究结果，对多形性腺瘤的肿瘤发生学进行了讨论。     

Expression of cytokeratins in Warthin's tumour (adenolymphoma) of parotid glands: Specific detection of individual cytokeratin types by monoclonal antibodies

This study evaluated the distribution of cytokeratins detected by monoclonal antibodies directed against individual keratin proteins in normal human salivary glands and epithelial tumour cells of Warthin's tumour arising in parotid glands to determine a more precise mapping of their cellular distribution. The normal salivary ducts showed the presence of cytokeratins 7, 8, 18 and 19 in the intercalated, striated and excretory ducts, the primary keratins of stratified and simple epithelia with a profile very similar to the non-cornified epithelium of the oral mucosa. The basally located cells of salivary gland ducts other than myoepithelial cells were reactive for keratins 7 and 19 suggesting a close similarity in profile of keratin in the basal cells of the oral epithelium. In Warthin's tumour, keratins 7, 8, 18 and 19 were consistently detected in the epithelial cells of the tumour, a profile with a tendency to mimic the same in normal ductal epithelium. The distribution, however, was diverse and a heterogeneity was observed in the basal and luminal cells of Warthin's tumour which differed even in different areas of the same tumour specimen.     

Expression of epithelial and nervous-system-related antigens on pleomorphic adenoma of the salivary glands--an analysis of 20 cases

The expression of cytokeratin (40-52 kD), carcinoembryonic antigen (CEA), vimentin, neuron-specific enolase (NSE), S-100 protein, glial fibrillary acidic protein (GFAP) were investigated in 20 cases of pleomorphic adenoma of the salivary glands and 10 cases of normal salivary glands, in order to analyze and correlate the antigens' expressions with the probably histogenetic mechanisms of the various histopathological differentiations in pleomorphic adenoma of the salivary glands and their probably original cells in normal salivary glands. Immunohistochemistry has provided some evidence for the relationship of the tumor cells to normal salivary glands: In the normal glands, the acinic cells exhibited cytokeratin, CEA and focal, predominantly nuclear S-100 protein staining. In both normal glands and pleomorphic adenomas, the duct-lining cells were immunoreactive for cytokeratin, CEA and had both cytoplasmic and nuclear S-100 positivity; The myoepithelial cells of the normal glands as well as the periduct cells, epithelial nests/cords, squamous metaplasia and the stellate/spindle/cartilaginous cells in the myxomatous-chondroid areas of the pleomorphic adenoma contain immunoreactive vimentin, NSE, S-100 proteins and GFAP, and lesser amounts cytokeratin (40-52 kD)/CEA. The varicosities of the terminal axon may lie directly on the basal membrane, or penetrate the basal membrane and lie in direct contact with the effector cells (duct-acinar-myoepithelial cells) of the salivary glands. The peripheral neurons and axons of the autonomic nervous system were identified by vimentin, NSE, S-100 proteins and GFAP. The combination of epithelial cytokeratin and nervous system-related vimentin, NSE, S-100 and GFAP immunostaining in myoepithelium of the normal glands and in all component elements (particularly the periduct cells) of pleomorphic adenoma reflects pleomorphic adenoma of the salivary glands is an epithelial tumor, the probably original cells or the probably histogenetic mechanisms of the various histopathological differentiations is correlated not only with "duct-acinar-myoepithelial cells" but also with the neuroectoderm in the normal salivary glands."     

The cellular composition of basal cell adenoma of the parotid gland: an immunohistochemical analysis

Four cases of basal cell adenoma of the parotid gland were examined immunohistochemically to characterize their cellular composition. In all cases epithelial membrane antigen and keratin were detected in the inner luminal cells; some cells also showed positive staining for secretory functional markers, indicating their differentiation toward secretory epithelium. In tubular and trabecular types the outer cells consistently displayed an intense staining for vimentin and some were also positive for actin, indicating their myoepithelial nature. In the solid type, most tumor cells resembled the ductal cells or basal cells of larger ducts in normal gland with regard to their immunoreactivity. Our results may suggest that the proportion and arrangement of heterogeneous tumor cells are responsible for different histologic patterns of the salivary basal cell adenoma.     

Irradiation effect of low-energy laser on rat submandibular salivary gland

Histopathological studies of rat submandibular salivary glands following low-energy laser irradiation using gallium-arsenide semi-conductor laser were conducted. The mitoses of duct epithelial cells without atypia increased between 1 and 24 h after irradiation, reaching a maximum of greater than 5 times control values by 24 h. Mitoses of duct epithelial cells had a tendency to be more frequent in granular ducts, less in striated ducts, and still less in intercalated ducts. Qualitative differences in the effect of low-energy lasers on salivary gland epithelia were also noted. This is the first experimental study of the effect of low-energy laser on salivary glands.