涎腺肿物针吸细胞学的分类诊断探讨

目的:探讨涎腺肿物针吸细胞学(FNAC)特点、诊断价值及误诊原因.方法:通过涎腺肿物针吸细胞学与病理组织学对照,回顾性分析102例涎腺肿物针吸细胞学特点.结果:356例涎腺FNAC中,有组织学对照102例,其中诊断正确91例,正确率89.2%;良性病变诊断准确率94.4%;良性肿瘤诊断准确率89.5%;恶性肿瘤诊断准确率82.4%.FNAC区分良恶性病变的诊断准确率为96.1%.结论:涎腺肿物针吸细胞学诊断是一种快速、简便的检查方法,对涎腺良恶性病变的诊断可靠、准确.对某些肿瘤的分类仍有局限性,需要活检诊断.     

147例涎腺肿瘤针吸细胞学与病理组织学诊断对照分析

目的总结涎腺常见肿瘤的针吸细胞学特征、诊断与鉴别诊断,提高细胞学的确诊率。方法回顾性分析147例针吸细胞学诊断的涎腺常见肿瘤,并与病理组织学进行对照。结果针吸细胞学诊断涎腺肿瘤的总符合率为91.84%,其中良性肿瘤定性诊断符合率为97.83%,准确率88.04%;恶性肿瘤定性诊断符合率为96.36%,准确率为78.18%。结论针吸细胞学诊断涎腺肿瘤准确率较高,它能为临床治疗提供可靠依据,是一项简便而有价值的诊断方法。     

涎腺肿物针吸细胞学的分类诊断探讨

目的：探讨涎腺肿物针吸细胞学（FNAC）特点、诊断价值及误诊原因。方法：通过涎腺肿物针吸细胞学与病理组织学对照，回顾性分析102例涎腺肿物针吸细胞学特点。结果：356例涎腺FNAC中，有组织学对照102例，其中诊断正确91例，正确率89．2％；良性病变诊断准确率94．4％；良性肿瘤诊断准确率89．5％；恶性肿瘤诊断准确率82．4％。FNAC区分良恶性病变的诊断准确率为96．1％。结论：涎腺肿物针吸细胞学诊断是一种快速、简便的检查方法，对涎腺良恶性病变的诊断可靠、准确。对某些肿瘤的分类仍有局限性，需要活检诊断。     

针吸细胞学诊断涎腺混合瘤的标准探讨

混合瘤是涎腺肿瘤最常见的一种,其针吸细胞学诊断需与涎腺的其他肿瘤鉴别。１材料与方法１．１临床资料 １９８６年１２月～１９９８年１２月之间,经针吸细胞学检查且病理组织学证实的７５例患者,其中６８例组织学为涎腺混合瘤,３例粘液表皮样癌,２例肌上皮瘤,２例神经鞘瘤。１．２方法 用１０ｍｌ注射器和外径０．７ｍｍ的针头常规针吸,涂片立即以 ９５％酒精固定, ＨＥ染色后镜检。２结果 ６８例涎腺混合瘤观察到６种形态变化,与其他肿瘤比较见附表。３小结 涎腺混合瘤吸出物均为半粘稠血性物,涂片时有粘液感。涂片由腺上皮和肌…     

涎腺肿块的细针吸取细胞学诊断分析

目的通过对细针吸取涎腺肿块细胞图片的形态学分析,研究细针吸取细胞学在涎腺肿块中的诊断价值。方法对179例涎腺肿块疾病行细针吸取细胞学涂片,用显微镜对涂片进行形态学分析,作出细胞学诊断,并与术后病理学诊断作比较。结果本组病例细胞学诊断的总体分类准确率为93.2％,特异性为94．3％;良性病变准确率为95％,特异性为94．4％;恶性肿瘤准确率为83．3％,特异性为88．2％。结论细针吸取细胞学对涎腺肿块的诊断具有操作简便、诊断快速、准确率高等优点,可作为涎腺肿块疾病的常规诊断方法应用。     

820例乳腺肿块针吸细胞学诊断分析

目的探讨我院乳腺肿块针吸细胞学诊断的准确率及误诊原因。方法分析820例乳腺肿块针吸细胞学检查结果,其中498例肿块切除后行组织学检查,比较针吸细胞学与病理组织学诊断结果。结果820例乳腺肿块中良性病变583例,恶性肿瘤237例,498例针吸细胞学与组织学诊断符合率为95.78%。结论乳腺肿块针吸细胞学诊断准确率高,能较准确地鉴别病变良恶性,对临床具有重要的指导意义。     

口腔颌面部肿块针吸细胞学诊断

行口腔颌面部肿块针吸细胞学检查197例,其中男121例,女76例,年龄7月～77岁。经病理组织学诊断为恶性肿瘤73例,良性肿瘤及瘤样病变121例。针吸细胞学诊断为恶性肿瘤68例,良性肿瘤及瘤样病变129例。二者结果完全相符134例(69.0％),基本符合(良、恶性)56例(28.4％),总符合率为96.1％。细胞学假阴性6例(3.1％),假阳性1例(0.5％)。涎腺是肿瘤好发部位,在本组占74例(37.6％)。其细胞学诊断准确性良性高于恶性,困难是混合瘤与腺样囊腺癌的区别。诊断     

3,541例乳腺病变针吸细胞学诊断——组织学对照及假阴性报告之探讨

自1978年7月至1986年6月,天津市肿瘤研究所细胞学室共作乳腺疾患针吸细胞学诊断10,816例。其中有3,541例作了手术及组织学检查,以此为对照,细胞学诊断为恶性准确率的89％,良性乳腺疾患之细胞学诊断准确率为90％,假阴性报告为6.8％。细胞学诊断之准确性受技术性限制,如针吸时错过小的病变及深部肿瘤,涂片标本上皮成分不足等造成诊断困难,即使对有经验的细胞学家来说,仅凭细胞分化良好,形态单一去鉴别良、恶性也常有失误,本文对此进行了初步探讨。     

16例涎腺肌上皮肿瘤临床病理及免疫组化分析

[目的]探讨涎腺肌上皮肿瘤的临床病理特征、免疫组化表达以及鉴别诊断.[方法]16例涎腺肌上皮肿瘤进行病理组织形态学及免疫组化观察.[结果]良性肌上皮瘤12例,恶性肌上皮瘤4例,组织形态均可分为上皮样细胞型,梭形细胞型,浆细胞样细胞型及透明细胞型.良、恶性肌上皮瘤的免疫组化染色S-100蛋白阳性率分别为91.7%(11/12),100%(4/4);SMA阳性率为66.7%(8/12),50%(2/4);Calponin阳性率91.7%(11/12),75%(3/4).[结论]涎腺肌上皮肿瘤的瘤细胞形态多样;S-100蛋白、SMA及Calponin等的免疫组化染色有助于诊断和鉴别诊断.     

涎腺上皮性癌临床病理观察

目的为了适应WHO涎腺上皮性癌分类的诊断,对其病理形态学诊断中应注意的问题以及术中快速切片诊断进行评估.方法对80例涎腺上皮性癌切除标本及术中40例快速切片行回顾性分析.结果涎腺上皮性癌占同期涎腺肿瘤的17.8%,主要以粘液表皮样癌、腺泡细胞癌、腺样囊性癌多见,肿块多无包膜且呈浸润性生长,术中快速切片诊断定性正确率85.0%.结论按WHO推出的涎腺上皮性癌的组织学分类对其肿瘤的生物学行为,组织形态学以及预后特点具有重要依据.术中快速切片诊断具有实用性和较高的可信度.     

Salivary Gland Tumors in Turkey: Demographic Features and Histopathological Distribution of 510 Patients

The aim of this study was to evaluate the demographic and clinicopathologic data of salivary gland tumors managed at a tertiary referral medical center in Turkey. The data of 510 patients with salivary gland tumors managed during the period of January 1984 to May 2012, were reviewed. Only primary neoplasms derived from salivary glands were included. Out of 510 neoplasms, 352 (69.0 %) were classified as benign and 158 (31.0 %) were classified as malignant. There was a male predominance and male:female ratio was 1.23 (281/229). The most common location was parotid gland (372/510, 72.9 %) followed by minor salivary glands (97/510, 19.0 %) and submandibular gland (40/510, 7.9 %). The malignancy rates were 21.5, 40.0, and 56.7 % in parotid, submandibular, and minor salivary glands locations, respectively. The most common location for minor salivary gland neoplasms was oral cavity (61/97, 62.9 %). Pleomorphic adenoma (PA) was the most common histopathological type (45.3 %) in the whole study group and also among pediatric patients. The most common malignant neoplasms were adenoid cystic carcinoma (39/510, 7.6 %) and mucoepidermoid carcinoma (5.7 %). Salivary gland tumors are more common in men. The malignancy rate is almost three times higher in neoplasms derived from minor glands when compared to parotid gland. PA is the most common histopathological tumor type in all locations and in all age groups.     

Expression of E-cadherin, cellular differentiation and polarity in epithelial salivary neoplasms

To investigate whether expression of E-cadherin correlates with polarised tissue organisation, grade or tumour type in salivary neoplasms, frozen sections from 30 salivary gland neoplasms were stained immunohistochemically for E-cadherin using the antibody HECD-1 and compared to the staining patterns in five samples of normal salivary gland. Lesions with areas of lack of staining were restained at two higher antibody concentrations. Normal salivary gland stained strongly around the periphery of acinar and ductal cells. Neoplasms mostly stained strongly regardless of neoplasm type. Reproducible loss of expression was found only in epithelial cells showing stromal or plasmacytoid (hyaline) differentiation in pleomorphic adenoma. Low- and high- grade mucoepidermoid carcinomas, adenocarcinoma NOS and carcinoma ex pleomorphic adenoma showed focal loss of expression but this was not related to tissue architecture, differentiation or invasiveness. We conclude that the relationship seen between E-cadherin expression and cell polarity/glandular organisation in breast and colon does not appear to exist for salivary gland neoplasms in which the diversity of architectural patterns precludes detection of any simple relationship. E-cadherin expression seems unlikely to be a useful marker for diagnosis or prognosis in salivary neoplasia in general.     

Salivary Gland Tumors: A Clinicopathologic Study of 366 Cases in Southern Iran

Background: Salivary gland tumors (SGT) are one of the most complex human neoplasms, demonstratingvariations in their clinicopathological profile related to racial and geographic differences. Few studies with largesamples have been reported in Iran. We here investigated a large group of patients in southern Iran. Materialsand Methods: In this retrospective study, all cases of primary epithelial salivary gland tumors, which had beenrecorded in a 5 years period from 2005-2009, were enrolled. Clinical data such as histopathologic type and site ofthe lesion as well as patients’ age and gender were analyzed. Results: Data of 366 cases of SGTs were recorded.Pleomorphic adenoma (80.2%) and adenoid cystic carcinoma (46.6%) were the most common benign andmalignant neoplasms. Male to female ratio (M/F) and the mean age of patients were 1:1.05 and 37.7 for benigntumors while they were 1.2:1 and 50.6 for malignant tumors, respectively. Parotid and minor salivary glandswere involved more frequently. Conclusions: Although the salivary gland tumours encountered were similar inmost of their characteristics to those reported in other countries, some differences such as relative frequencyand age and gender prevalence were discovered. These findings should help surgeons and pathologists for moreaccurate diagnosis, management and treatment.     

Fine Needle Aspiration Cytology Utility in Salivary Gland Tumor Diagnosis

We aimed to improve the diagnostic accuracy of tumors by using immunocytochemistry (IHC) on destained smears to correlate the cytological findings with histopathology and/or IHC for final evaluation of results. We have done a randomized and prospective double-blind study. Forty-six clinically suspected patients of salivary gland tumor were enrolled for study. Those with non-neoplastic\ inflammatory salivary gland pathologies and swellings other than salivary gland origin were excluded from the study. The Fine needle aspiration cytological (FNAC) diagnosis of all the patients was compared with the corresponding histopathology. Sensitivity and specificity of FNAC in diagnosing malignancy were 91.3 and 100 %. Diagnostic accuracy of FNAC for malignant tumors was 95.65 %. In our study kappa value came out to be 0.88 (p value <0.00), which indicated an excellent agreement between histological and cytological typing of salivary gland tumors. FNAC is a highly sensitive and specific technique for diagnosis of salivary gland tumors. Histopathology however is the gold standard for diagnosis, classification and grading of tumors. Immuno-cytochemistry can act as adjuvant in diagnosing salivary gland tumors, however it did not help in improving the diagnostic accuracy of FNAC in our study. Considering an excellent agreement between cytology and histology, a type specific diagnosis can be reached on FNAC of salivary gland tumors.     

The range and demographics of salivary gland tumours diagnosed in a UK population

Salivary gland tumours are relatively rare and comprise a diverse range of neoplasms. The aim of this study was to determine the range and demographics of all histologically diagnosed salivary tumours in a European population. All entries for salivary gland tumours from 1974 to 2005 inclusive were retrieved and analysed for each diagnosis including number of specimens, male:female ratio and age range. These data were then analysed for the distribution of benign and malignant salivary tumours in major and minor salivary glands. 58,880 specimens were received; of these, 741 cases (1.3% of all specimens) were diagnosed as salivary gland tumours with a male to female ratio of 0.7:1. There were 481 (64.9%) benign and 260 (35.1%) malignant neoplasms, with the most common tumours being pleomorphic adenoma and mucoepidermoid carcinoma, respectively. Our study provides demographic data on a large series of salivary gland tumours in a European population. Accurate diagnosis is essential as salivary lesions have diverse clinical and prognostic outcomes. This study has confirmed that some tumours have a predilection for certain sites and that the risk of malignant disease is also greater at specific sites within the oral cavity.     

多药耐药基因在涎腺粘液表皮样癌中的表达及意义

目的探讨涎腺粘液表皮样癌多药耐药基因MDR1/P-gp的表达情况及其临床意义。方法应用免疫组织化学技术(EnVision法)检测36例涎腺粘液表皮样癌(其中高分化组21例、低分化组各15例)以及15例正常涎腺组织中MDR1/P-gp的表达。结果MDR1/P-gp在粘液表皮样癌及正常涎腺组织中均有不同程度表达,阳性部位主要见于细胞膜。高分化粘液表皮样癌、低分化粘液表皮样癌和正常涎腺组织MDR1/P-gp表达阳性率分别为81.0%(17/21)、73.3%(11/15)和26.7%(4/15),组间两两比较均具有显著性差异(P<0.01)。结论MDR1/P-gp是涎腺粘液表皮样癌多药耐药产生的重要细胞机制,检测MDR1/P-gp可为临床拟定化疗方案提供依据,也可作为判断涎腺粘液表皮样癌组织分化程度及预后的参考指标。     

Mucoepidermoid carcinoma of salivary glands in children and adolescents: assessment of proliferation markers

Malignant neoplasms represent one-third of all pediatric salivary gland tumors. Mucoepidermoid carcinoma (MEC) composes 51% of malignant tumors and 16% of all salivary gland neoplasms in pediatrics. Prognostic factors in MEC in pediatric patients have not been well defined. Histopathologic features, clinical outcomes and proliferation markers in 26 pediatric patients (median age 11 years; 19F:7M) with salivary gland MECs were evaluated retrospectively. MEC histocytologic grading used a three-tiered system. Proliferation was assessed by determining the percentage of tumor cells immunoreactive for PCNA and Ki-67. Tumor site was 16 parotid, eight submandibular, one base of tongue and one maxillary lip. Median tumor size was 2.5 cm (range 1.5-5 cm). MEC grade was nine low grade (LG), 15 intermediate grade (IG) and two high grade (HG). Metastatic disease and capsular invasion occurred in five cases, while perineural invasion was noted in three cases. Mean percentage of tumor cells immunoreactive for proliferation markers is as follows: PCNA: LG 9%, IG 17%, HG 32%; and Ki-67: LG 7%, IG 12%, HG 26%. Treatment was surgical in 21 cases, and surgery with chemotherapy and radiotherapy in five cases. Two patients with high grade MECs died of disease (21, 44 months). Twenty-four patients had no evidence of disease at a median follow-up of 104 months (range 30-298 months). MECs were second malignancies in two children with prior radiotherapy and chemotherapy for leukemia and histiocytosis. Low and intermediate grade salivary gland MECS in a pediatric population may have a favorable outcome when compared with high grade MECs. Proliferation markers appear to be linked to histocytologic MEC grade and may provide information regarding biologic behavior of salivary gland MECs in children and adolescents.     

Tumor markers in parotid gland carcinomas: immunohistochemical investigations

Substances with "marker" characteristics for tumors were studied in parotid gland neoplasms. The substances included intermediate-sized filaments, oncofetal and proliferation antigens, metalloproteins, antigens related to the blood group system, and enzymes and other cellular products. The immunoperoxidase technique was applied on the following kind of tissues: normal parotid glands, Morbus Sj?gren, cystadenolymphomas, pleomorphic adenomas, adenocarcinomas, adenoid cystic carcinomas, salivary duct carcinomas, mucoepidermoid tumors, squamous cell carcinomas, and anaplastic carcinomas. The intermediate-sized filaments of the prekeratin type were demonstrated in the ducts and myoepithelial cells of the normal parotid glands, and in the epithelial tumors, which all were vimentin negative. Carcinoembryonic antigen was found in squamous cell carcinomas and glandular differentiated tumors, whereas lactoferrin was detected only in a part of glandular tumors. Amylase was seen in acinic cell tumors.