涎腺基底细胞腺瘤的临床病理观察

本文对１７例涎腺基底细胞腺瘤进行了临床病理及Ｓ一１００蛋白和ＣＥＡ免疫组织化学观察。结果显示：男性７例，女性１０例，平均年龄５０岁。该瘤大多数发生在腮腺（８８％），组织学上分为实性、梁状和管状三个亚型。Ｓ一１００蛋白染色肿瘤细胞呈阴性；ＣＥＡ染色肿瘤的腺管样结构呈阳性着色，而实性上皮团块或条索中则不表达ＣＥＡ，提示该瘤的实性或条索的细胞分化低。     

涎腺基底细胞腺癌的临床病理和免疫组织化学观察

作者应用细胞性角蛋白、肌动蛋白、波形蛋白、Ⅳ型胶原单克隆抗体和Ｓ—１００蛋白、胶质纤维酸性蛋白、溶菌酶、纤维凝集素、癌胚抗原多克隆抗体对涎腺基底细胞腺癌进行了免疫组织化学研究，结果肿瘤由对溶菌酶和细胞性角蛋白呈阳性反应的腺上皮细胞和对肌动蛋白、波形蛋白、Ｓ—１００蛋白呈阳性反应的肌上皮细胞构成。本文还对涎腺基底细胞腺癌的临床病理学特征和鉴别诊断进行了讨论。     

涎腺肌上皮瘤的临床病理分型和免疫组化研究

对从１８７３例涎腺肿瘤复查后确诊的４３例涎腺肌上皮瘤进行了临床病理学和免疫组化研究。结果显示：该瘤的患病率约占涎腺肿瘤的２．３％，好发于腮腺（４８．８４％）和腭腺（４１．８６％）；该瘤在病理上可分为５型：即上皮细胞型、梭形细胞型、浆细胞样细胞型、透明细胞型和混合细胞型，其实质细胞——肿瘤性肌上皮细胞为一个连续变化的瘤细胞谱，各种形态的瘤细胞可以互相转化；免疫组化ＣＫ－１８、ａｃｔｉｎ染色显示上述各型瘤细胞均为程度不等的阳性。作者认为提高该瘤确诊率的关键是对各型瘤细胞的认识；联合应用ＣＫ－１８、ａｃｔｉｎ有助于该瘤的诊断和与多形性腺瘤的鉴别。     

15例涎腺淋巴上皮病变的临床病理分析

目的 对涎腺淋巴上皮病变作一较全面的认识，方法 对1980年至今收治的15例涎腺淋巴上皮病变进行临床病理分析。结果 涎腺淋巴上皮病变一般为良性过程，但具有肿瘤的特性，也有恶变可能，良性的组织学形态基本相同，恶变则有上皮成分恶变和淋巴成分恶变两种可能。结论 涎腺淋巴上皮病变应按涎腺肿瘤的原则进行手术，恶变者术后给予化疗和放疗，以防复发。     

8例涎腺透明细胞癌临床病理分析

目的:探讨涎腺透明细胞癌(CCCs)生物学特性和组织来源。方法:收集8例涎腺透明细胞癌标本,采用免疫组化方法和文献回顾对涎腺透明细胞癌进行研究分析。结果:透明细胞癌EMA和CK8全阳性表达(8/8、100/100),Ck18和CK-HMW小部分阳性表达(各2/8、25/100),S-100仅1例阳性表达。SMA、Calpon in和P53无表达,bc l-2全阳性表达,PCNA阳性表达率为72.25%。结论:涎腺透明细胞癌是腺上皮性肿瘤,肿瘤细胞增殖活跃,是一种低度恶性肿瘤。     

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256例临床病理分析

涎腺肿瘤２５６例临床病理分析湖北医科大学附属口腔医院外科（４３００７０）许丽萍钟林生王秀丽我科１９８５年－１９９０年共收治涎腺肿瘤２５６例，其诊断均经病理证实，本文就其临床及病理资料分析如下。临床资料１、性别和年龄：男性１３５例，女性１２１例，男女之...     

14例涎腺基底细胞腺癌的临床病理分析

目的 总结涎腺基底细胞腺癌的临床及病理特点、生物学行为及治疗效果。方法 对１４例涎腺基底细胞腺癌患者进行临床病理分析。结果 其临床特点为：女性多于男性,发病部位以小涎腺为常见,颈淋巴结转移率为２１．４％,远处转移率为１４．３％,患者预后相对较差。组织病理表现类似于基底细胞腺瘤,但有较多核分裂象和浸润性生长的特点。结论 其生物学行为为属中度恶性肿瘤,治疗以根治性切除为主,病变广泛者可考虑选择性颈淋巴     

核因子кB与涎腺腺样囊性癌微血管密度、临床病理及预后的关系

目的 检测涎腺腺样囊性癌（ACCs）中核因子KB（NF-kB）p65的蛋白表达水平和微血管密度（MVD），并探讨二者与ACCs临床病理及预后的关系。方法用免疫组化法检测80例ACCs中NF-kBp65的表达，并以正常涎腺组织作对照；用CD34标记肿瘤血管内皮细胞计数肿瘤MVD，并对所有病例进行随访。结果NF-kB p65的表达与肿瘤MVD呈显著正相关（P〈0．01）。NF-kB p65和肿瘤MVD与ACCs的大小、TNM分期、组织学类型、侵犯血管和神经、复发及远处转移有关（P〈0．05）。NF-kB p65的表达、肿瘤MVD、肿瘤组织学类型及侵犯神经是影响ACCs预后的独立因素（P〈0．05）。结论ACCs中NF-kB p65的异常高表达与MVD呈正相关，且二者可视为影响ACCs预后的重要因素。     

Mucinous adenocarcinoma of the sublingual gland

A case of mucinous (colloid) adenocarcinoma of the sublingual gland is reported. Adenocarcinomas associated with large pools of extracellular mucin are extremely rare in the major salivary glands. Analysis of the tumor for cytokeratin expression, estrogen and progesterone receptors was performed. Predominantly, the tumor expressed cytokeratins 7, 8, 18 and 19 that are commonly found in simple epithelia, and to a lesser degree cytokeratins 4 and 13 which are usually found in complex epithelia. Staining for estrogen and progesterone receptors was negative. No other cancer has been detected for three years after the first examination. The tumor is considered to be a primary mucinous adenocarcinoma of the sublingual gland.     

涎腺腺癌中NOS和VEGF的表达与血管生成及临床病理分析

目的 研究血管内皮生长因子（VEGF）、诱导型一氧化氮合酶（iNOS）和内皮型一氧化氮合酶（eNOS）在涎腺腺癌中表达的相关性；探讨三者与涎腺腺癌血管生成和临床病理特征的关系；研究一氧化氮（NO）和VEGF的相互作用及N0在VEGF促肿瘤生长中的作用机制。方法 应用免疫组织化学方法检测47例涎腺腺癌手术切除标本VEGF、iNOS和eNOS的表达，第Ⅷ因子相关抗原（FⅧRAg）血管内皮细胞特异性染色计数肿瘤微血管密度（MVD）。结果 ①30例涎腺腺癌组织表达VEGF，31例表达iNOS，33例表达eNOS；②VEGF与iNOS的表达正相关，与eNOS的表达无相关；③VEGF、iNOS的表达与涎腺腺癌MVD呈正相关，eNOS的表达与涎腺腺癌MVD的差异无显著性意义；④VEGF的表达与涎腺腺癌淋巴结转移和肿瘤分化程度正相关，与临床分期无关。iNOS表达与涎腺腺癌的分化程度及临床分期和有无淋巴结转移正相关；eNOS表达与涎腺腺癌临床分期和分化程度及有无淋巴结转移均无关。结论 ①VEGF表达与iNOS表达具有明显的相关性，iNOS对VEGF的生成和发挥作用的过程可能有一定影响；②MVD随着VEGF和iNOS表达的增强而增加，说明两者对涎腺腺癌血管生成具有促进作用。     

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。     

涎腺透明细胞癌10例临床病理分析

目的 分析涎腺透明细胞癌(CCC)的临床病理特征。方法 对上海第二医科大学附属第九人民医院口腔医学院口腔病理科在1985年1月至2004年5月期间诊断为涎腺肿瘤的病例进行回顾性分析，确诊了10例CCC，并进行临床病理分析及随访。结果 10例CCC部位：7例腭部、1例舌根、1例磨牙后区、1例口底，男、女性各5例，平均年龄为55岁。光镜下肿瘤主要由排列成小梁状、带状、巢状、团块状的透明细胞及少量嗜酸性细胞组成，细胞周围常有玻璃样变物包绕。免疫组化：10例肿瘤细胞EMA、CK8呈阳性表达，5例CK18呈阳性表达，2例CKHMW呈阳性表达，CK10／13、S-100、SMA、Calponin均呈阴性表达。8例随访患者术后均无复发或转移。结论 CCC是一种独立的、低度恶性的涎腺肿瘤，好发于小涎腺，肿瘤可能来源于闰管储备细胞。     

超声弹性成像在唾液腺非肿瘤疾病中的应用进展

超声弹性成像技术近年来发展迅速,可对组织硬度进行定性、定量评估,常用于全身多器官病变的无创评估,操作简单、可重复性高、结果更加客观。目前,超声弹性成像可用于区分正常组织与病变组织,其对唾液腺疾病的诊断与鉴别诊断也提供了有价值的信息。本文就超声弹性成像技术的原理与技术,以及在唾液腺非肿瘤疾病中的应用进行综述。     

Epithelial-stromal interactions in salivary glands of rats exposed to chronic passive smoking

Objectives

Cigarette smoke leads to precancerous and cancerous lesions in the mouth even when the exposure is passive. The salivary glands are amongst the tissues exposed to the smoke but it is unclear whether or not passive cigarette exposure is related to detectable changes in these tissues. The objective of this study was to observe the tissue architecture of the parotid and submandibular glands in rats after passive cigarette exposure and to measure any changes that occurred.

Design

Twenty Wistar rats were divided into 10 non-smoking animals and 10 animals exposed to cigarette smoke. After 6 months of smoke exposure samples were collected from both exposed and unexposed salivary glands for histological examination under both transmitted and polarized light microscopy.

Results

Changes in the glands of exposed animals included involution of the cytoplasm and nucleus of the acinar cells and the presence of an inflammatory infiltrate. There was an abnormal accumulation of type I collagen in the stroma and an enlarged interacinar space filled with extracellular matrix.

Conclusion

Passive smoking led to substantial structural changes in the salivary glands which could significantly affect function.     

Effects of hyperleptinemia in rat saliva composition,histology and ultrastructure of the major salivary glands

ObjectiveTo study the effect of the satiety hormone, leptin, in saliva proteome and salivary gland histology and ultrastructure.DesignIncreases in blood leptin levels were induced through mini-pump infusion in male Wistar rats, during a period of 7 days. Saliva was collected before and at the end of the experimental period, for proteomic analysis, and major salivary glands were collected, at the end, for biochemical, histological and ultrastructural analysis.ResultsImmunohistochemistry revealed the presence of leptin receptors in major salivary glands. Salivary amylase levels and enzymatic activity were decreased in saliva, whereas the enzymatic activity of this protein was increased in the cytosol of parotid gland cells. Transmission electron microscopy allowed the observation of high number of electron-dense granules in cytosol of parotid acinar cells, from leptin treated animals.ConclusionsIncreased levels of plasmatic leptin result in changes in saliva composition and salivary glands function. To our knowledge, this is the first study providing evidences for a potential role of leptin in salivary gland secretion and saliva composition. An understanding of how appetite/satiety factors influence saliva composition and how this composition influences food processing in mouth may be relevant in understanding ingestivebehaviour.     

Analysis of age-related changes in the functional morphologies of salivary glands in mice

Background and Objectives

Salivary glands in the elderly commonly exhibit salivary dysfunction resulting dry mouth, poor oral hygiene, and dental caries. However, in vivo changes of salivary glands during aging have not been well documented in the literature. This study was undertaken to determine age-related morphometric and functional changes of salivary glands using an aging mouse model.

Methods

Male C57BL/6 mice were divided into three groups, group A (10 weeks old; n = 10), group B (30 weeks old; n = 10), and group C (90 weeks old; n = 10). Body weights, salivary gland weights, salivary flow rates, and salivary lag times were measured and compared. Histomorphometric examinations and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays were performed. In addition, changes in salivary uptake and excretion were observed by single-photon emission computed tomography (SPECT).

Results

Body and gland weights increased with age. Gland weight was significantly higher in group B than in groups A and C. Salivary lag time was significantly greater in group C than in groups A and B, and salivary flow rate was significantly greater in group B than in groups A and C. Histologic evaluations exhibited acinar cell atrophy, cytoplasmic vacuolization, lymphocyte infiltration, small mucin component and more periductal fibrosis in salivary glands of group C. TUNEL assays revealed that apoptotic salivary epithelial cells were significantly more numerous in group C than in groups A and B. ^99mTc-pertechnetate excretion rate was significantly lower in group C than in groups A and B in SPECT.

Conclusion

Various morphometric and histopathological changes were observed in the salivary glands of aging mouse as well as relevant functional alterations, such as, decreased saliva production and excretion. Increased number of apoptotic salivary epithelial cells may contribute to the observed functional deterioration.