谷胱甘肽过氧化物酶-3在腮腺多形性腺瘤中的表达及意义

目的 :研究谷胱甘肽过氧化物酶-3(glutathione peroxidase-3,GPX-3)基因及蛋白在腮腺良、恶性多形性腺瘤中的表达,以明确GPX-3与腮腺多形性腺瘤发生、发展的相关性,为临床预测腮腺多形性腺瘤的发生及恶变提供理论依据。方法:采用荧光定量PCR和蛋白免疫印迹法检测30例腮腺多形性腺瘤,30例腮腺多形性腺瘤的瘤旁2 cm腺体组织,以及10例恶性腮腺多形性腺瘤中的GPX-3 mRNA及蛋白的表达,对其相对表达量进行统计学分析。结果:GPX-3 mRNA和蛋白在腮腺良、恶性多形性腺瘤中的表达明显低于瘤旁腺体组织,且在腮腺恶性多形性腺瘤中的表达最低,差异有统计学意义(P<0.01)。GPX-3在腮腺多形性腺瘤中的表达与患者的年龄、性别及肿瘤大小无关,差异无统计学意义(P>0.05),且GPX-3在腮腺多形性腺瘤中的表达与肿瘤TNM分期及恶性成分比例有关,其差异有统计学意义(P<0.05)。结论:GPX-3在腮腺良性多形性腺瘤中低表达,且在腮腺恶性多形性腺瘤中的表达最低,提示GPX-3的低表达与腮腺多形性腺瘤的发生及恶变密切相关。     

PTEN基因在腮腺多形性腺瘤中的表达及意义

目的:探究PTEN基因在腮腺多形性腺瘤的发生中基因水平上的作用。方法:将手术切除并经病理检查确诊的腮腺多形性腺瘤、腮腺多形性腺瘤瘤旁1cm腺体组织和舌下腺组织(舌下腺结石摘除的腺体)标本各30例,采用免疫组化法分析各组之间PTEN表达水平的差异性。结果:PTEN在腮腺多形性腺瘤中表达的阳性率低于腮腺多形性腺瘤瘤旁1 cm腺体组织,差异有统计学意义(P<0.05);PTEN在腮腺多形性腺瘤中表达的阳性率低于舌下腺组织,差异有统计学意义(P<0.05);腮腺多形性腺瘤瘤旁1 cm腺体组织与舌下腺组织两组比较,差异无统计学意义(P>0.05)。结论:PTEN基因的阳性表达对腮腺多形性腺瘤的发生有抑制作用。     

MMP-9和VEGF在腮腺多形性腺瘤中的表达研究

目的 研究MMP-9和VEGF在腮腺多形性腺瘤中的表达情况及其与肿瘤良恶性的关系。方法 应用荧光实时定量PCR和Western blotting方法检测32对多形性腺瘤及其瘤旁组织中MMP-9和VEGF的表达。结果 32例多形性腺瘤中26例为良性,6例为恶性。MMP-9和VEGF的mRNA和蛋白表达量在多形性腺瘤组织中高于瘤旁组织（P＜0.05）;在恶性多形性腺瘤组织中高于良性多形性腺瘤组织（P＜0.05）。结论 MMP-9和VEGF在腮腺多形性腺瘤中高表达,并且可能与腮腺多形性腺瘤的恶变相关;腮腺多形性腺瘤肿瘤外1 cm为安全切除界限。     

原发多灶性腮腺多形性腺瘤1例报告及文献复习

该文通过报道1例原发多灶性腮腺多形性腺瘤患者的临床资料,并进行文献复习。此例原发多灶性腮腺多形性腺瘤发现及时,在右侧腮腺中发现两个独立存在的多形性腺瘤,病理诊断明确,手术彻底,愈后良好。原发多灶性腮腺多形性腺瘤罕见,术前影像学检查、术中详细触诊和手术方式的选择具有重要意义。     

肋腺深叶肿瘤摘除术式的探讨

随着临床医师对腮腺部肿瘤性质的认识和对治疗效果的长期观察,人们认为手术摘除肿瘤与腺体保留面神经是治疗腮腺部多形性腺瘤的一种理想方法。目前在临床上对腮腺深叶较大的多形性腺瘤或对侵犯咽旁间隙的腮腺深叶的多形性腺瘤诊断并不困难,但     

CD44v6在腮腺多形性腺瘤中的表达

初步研究CD44v6在腮腺多形性腺瘤中的表达情况及其与肿瘤复发的关系.采用免疫组织化学SP法对初次手术后复发,又再次入院行复发灶切除术的多形性腺瘤病例10 例2 次术后石蜡标本及10 例正常腮腺组织石蜡标本进行CD44v6检测,分析其与腮腺多形性腺瘤复发关系.结果表明CD44v6在肿瘤组织中的表达高于正常腮腺组织,在复发多形性腺瘤中呈现低表达.CD44v6的表达变异可能与腮腺多形性腺瘤的复发有关.     

腮腺多形性腺瘤及其恶变中β-连环蛋白、细胞周期蛋白D1的表达

目的：检测正常腮腺组织、腮腺多形性腺瘤（Pleomorphicadenoma,PA）和癌在多形性腺瘤中（Carcinomainpleomorphicadenoma,CPA）β-连环蛋白（B—catenin）和细胞周期蛋白D1（CyclinDD的表达情况,探讨β-catenin、CyclinDl在腮腺多形性腺瘤发生、复发及恶变中的可能作用。方法：用免疫组化s—P法结合计算机图像分析技术检测10例正常腮腺组织、10例腮腺多形性腺瘤、10例腮腺多形性腺瘤瘤旁组织、15例腮腺多形性腺瘤复发、11例癌在多形性腺瘤中β-catenin及CyclinDl的表达情况。结果：β-catenin在10例正常腮腺组织中均呈正常表达,而CyclinDl表达均呈阴性;,β-catenin、CyclinD1在腮腺PA瘤旁组织、PA、PA复发、CPA组织中的表达率及表达水平逐渐升高,且CPA组与其它各组相比均有显著性差异。结论：腮腺PA、CPA中均存在β-catenin异常表达和CyclinDl的过表达,提示β-catenin的异常表达激活CyclinD1引起细胞增殖和分化失控,在腮腺PA及CPA发生中可能具有一定作用。     

腮腺浅叶多形性腺瘤包膜外扩大切除术32例分析

腮腺肿瘤以多形性腺瘤最多见,手术切除为主要治疗手段。腮腺多形性腺瘤的生物学特性和生长方式,复发率与手术的方法和术式有直接的关系。本文为探讨腮腺多形性腺瘤包膜外扩大切除术的效果,对32例手术作一总结。     

腮腺深叶多形性腺瘤的诊断及治疗

<正> 多形性腺瘤是涎腺中最常见的肿瘤,好发于腮腺,其中约10％腮腺多形性腺瘤发生于腮腺深叶组织。对于发生在腮腺深叶的多形性腺瘤,在诊断治疗上都有一定的难度,较易误诊误治。近2年来,我们收治了6例腮腺深叶多形性腺瘤患者,本文就其术前诊断、鉴别诊断、手术术式的选择加以讨论。     

人腮腺多形性腺瘤细胞的体外培养

目的:建立人腮腺多形性腺瘤有限细胞系.方法:取腮腺多形性腺瘤患者原发肿瘤进行原代培养.观察细胞的形态特征,绘制细胞生长曲线,采用免疫细胞化学检测细胞内特异性抗原标志物,对细胞进行鉴定.结果:多形性腺瘤细胞体外培养时间约为80d,传代至16代,细胞呈短梭形、多边形,肿瘤性腺上皮细胞角蛋白弱阳性,肿瘤性肌上皮细胞肌动蛋白阳性、波形蛋白阳性.结论:多形性腺瘤细胞在体外培养连续传代,为永生化腮腺多形性腺瘤细胞系的建立奠定了基础.     

Fas-FasL在腮腺多形性腺瘤及腺样囊性癌中的表达及意义

目的　观察Fas FasL系统在腮腺正常组织、多形性腺瘤及腺样囊性癌中的表达 ,并探讨其意义。方法　应用免疫组化及图像定量分析技术 ,检测 2 1例正常腮腺、3 5例腮腺多形性腺瘤、3 2例腮腺腺样囊性癌中Fas和FasL的表达 ,并进行统计学处理。结果　Fas及FasL在腺样囊性癌中呈阴性表达 ,且与组织学类型、病理分级无相关性 ;而在正常腮腺及腮腺多形性腺瘤中均有明显表达 ,但多形性腺瘤中Fas及FasL表达低于正常腮腺 ,其差异具有显著意义 (P <0 .0 1)。结论　Fas FasL系统的表达及介导的凋亡失调与腮腺多形性腺瘤和腺样囊性癌的发生、转归有重要关系     

抑癌基因PTEN在腮腺肿瘤中的突变与缺失

目的：探讨抑癌基因PTEN在腮腺多形性腺瘤及腮腺粘液表皮样癌的发生、发展过程中的作用：方法：应用聚合酶链反应(PCR)及克隆、基因测序的方法来分析腮腺多形性腺瘤、腮腺粘液表皮样癌及正常腺体组织中PTEN基因第5、第6及第8外显子有无突变及缺失。结果：通过对PTEN基因3个外显子的克隆测序，发现有2例腮腺多形性腺瘤外显子8发生突变，其中1例引起编码的氨基酸发生变化；而腮腺粘液表皮样癌中均未发现有突变及缺失。结论：初步推断，在DNA水平抑癌基因PTEN在腮腺多形性腺瘤中存在突变，在其发生发展过程中可能起到一定的作用；在DNA水平抑癌基因PTEN在腮腺粘液表皮样癌的发生过程中可能不起重要作用。     

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目的 探讨采用肿瘤及其就位腺体区域性切除的方法治疗腮腺浅叶良性肿瘤的可行性。方法 对2004—2006年甘肃嘉峪关市第一人民医院口腔科收治的28例腮腺浅叶良性肿瘤患者,采用肿瘤及其就位腺体区域性切除+局部面神经解剖并且保留腮腺主导管的术式治疗,术后随访观察疗效。结果 28例腮腺浅叶良性肿瘤患者治疗后,经过3～5年的随访无一例复发,均达到治愈目的。术后并发症：出现面神经颧支暂时性瘫痪1例,颊支暂时性瘫痪2例,经应用营养神经药物治疗,1 ~ 3个月后均恢复正常;发生腮腺局部积液4例,经穿刺抽液换药,加压包扎后均得到痊愈,无一例涎瘘发生;出现味觉出汗综合征1例,但范围较小;愈后检查患者,手术侧凹陷不明显,面部左右基本对称,腮腺检查分泌功能基本正常。结论 肿瘤及其就位腺体区域性切除的方法是治疗腮腺浅叶多形性腺瘤或其他良性肿瘤合适的手术方式。与标准的保留面神经的肿瘤及腮腺浅叶或全腮腺切除术相比,能减少面神经损伤、涎瘘、味觉出汗综合征的发生,更重要的是能够保持面部形态的对称性,避免畸形等并发症的发生。     

Synchronous occurrence of ipsilateral synovial chondromatosis of the temporomandibular joint and pleomorphic adenoma of the parotid gland

We present a unique case characterized by true coexistence of synovial chondromatosis (SC) of the temporomandibular joint (TMJ) with a salivary gland tumor, specifically pleomorphic adenoma, of the ipsilateral parotid gland. The possibility that the condition was the result of a single pathologic entity, ie, SC with extracapsular involvement or pleomorphic adenoma affecting the TMJ, received strong consideration. Nonetheless, careful assessment of the clinical, radiographic, MRI, and surgical findings strongly suggested the synchronous occurrence of 2 separate pathologic processes, despite their close proximity. Further, histopathologic examination confirmed the presence of both SC of the TMJ and pleomorphic adenoma of the superficial lobe of the ipsilateral parotid gland. Previous reports have pointed out the possibility of misdiagnosing extracapsular spread of SC as a salivary gland tumor. Vice versa, it has been noted that parotid gland tumors, especially malignant, may cause TMJ symptoms similar to those of SC. However, to the best of our knowledge, this is the first time that true synchronous occurrence of ipsilateral SC and pleomorphic adenoma, or parotid tumor of any kind, is reported.     

Surgical treatment of pleomorphic adenoma of the parotid gland: report of 110 cases

One hundred benign and ten malignant pleomorphic adenomas of the parotid gland were analyzed. Follow up ranged from two to 20 years. Of 54 cases of benign pleomorphic adenoma of the parotid gland, recurrence was noted in five cases (9.2%). The five-year recurrence rate was 17.2%. Of the six malignant pleomorphic adenoma, recurrence within the first ten years took place in four patients (66.6%).     

腮腺复发性多形性腺瘤的临床分析--附22例报告

目的：探讨腮腺多形性腺瘤复发、恶变的原因及临床治疗方法。方法：对22例腮腺多形性腺瘤复发患者进行回顾性分析和追踪调查。结果：多数腮腺多形性腺瘤复发病例肿块呈多灶性（18／22），手术越简单其复发率越高，复发间期越短（P＜0．05）。22人中有7例发生恶变，占31．8％，恶变与初发年龄较大有关（P＜0．05），与手术次数关系不大。末次手术分别采用浅叶切除术，腮腺全切术、扩大切除术，对7例有恶变者于术后辅以放射治疗。术后平均追踪54月，除1例多形性腺瘤恶变者于术后30月时肿瘤复发外，其余均未见复发。结论：不恰当的手术方式是导致腮腺性多形性腺瘤复发的直接原因。     

Expression of CD44 standard and variant isoforms in parotid gland and parotid gland tumours

In this study, we investigated the distribution of the standard form of the CD44 (CD44s) cell adhesion molecule and of its v3 and v6 isoforms in samples of foetal and adult parotid gland tissue, in comparison with samples of parotid gland adenomas and carcinoma ex pleomorphic adenoma. Foetal parotid gland showed CD44s and CD44v3 expression in the peripheral small primordial ducts and acini, while CD44v6 was only focally expressed. Adult parotid gland tissue showed a similar distribution of CD44s and variants, with a predominant expression in acinar structures and a weaker expression at duct level. In parotid gland adenomas, a diffuse and intense expression of CD44s and variants 3 and 6 was observed only in pleomorphic adenomas, while expression of CD44s was prevalent in Warthin's tumour, myoepithelioma and oncocytoma. The malignant areas of carcinoma ex pleomorphic adenoma showed a markedly decreased expression of CD44v3 and CD44v6 in comparison with the adjacent pleomorphic adenoma component. In conclusion, the prevalent expression of CD44s and variants in pleomorphic adenoma in comparison with other adenomas may be related to the abundant extracellular matrix production present in these tumours, while loss of CD44v3 and CD44v6 associated with the onset of carcinoma ex pleomorphic adenoma could promote stromal invasion, eventually contributing to the development of distant metastases.     

Current thinking about the management of recurrent pleomorphic adenoma of the parotid: a structured review

Pleomorphic adenoma is the most common tumour of the parotid gland, and can recur after excision. Recurrent pleomorphic adenoma can be a challenge to treat, and has variable outcomes. The aim of this review was to summarise current thinking in its management, which may be helpful to clinical teams and could improve patients’ health-related quality of life. We searched several online databases using the key terms pleomorphic adenoma, recurrent pleomorphic adenoma, parotid gland tumours, parotid surgery, radiotherapy and parotid pleomorphic adenoma, and parotid surgery outcomes. Information collected included sample size, recurrence rate, condition of the facial nerve, type of operation, adjuvant treatments associated with recurrence, and clinical outcome. We screened 2301 papers, of which 49 were eligible. There was no consensus among authors about management. There are few if any randomised studies, and so conclusions in most papers were based on coherent arguments. Pleomorphic adenomas of the parotid tend to recur after long intervals, with a propensity towards multifocal disease, and the risk of recurrence (which depends on the initial surgical technique) is higher when the initial operation was done at a young age, after enucleation, and if the initial margins were invaded. Published conclusions suggest that the accepted management varies from observation in selected cases to total parotidectomy with or without postoperative radiotherapy.     

同侧腮腺同时存在2种不同肿瘤1例报告

腮腺肿瘤为头颈部常见肿瘤之一,多发性腮腺肿瘤临床上比较少见,而同侧腮腺内同时存在不同病理类型的病例更为罕见.本文报告1例同侧腮腺同时存在基底细胞腺瘤和多形性腺瘤的病例,并结合相关文献进行讨论.