涎腺恶性多形性腺瘤的病理类型

本文报告73例涎腺恶性多形性腺瘤,根据光镜形态分为9个亚型,即腺癌型、鳞癌型、肌上皮癌、低分化癌、癌肉瘤、腺样囊性癌、粘液表皮样癌、多形性腺癌、转移性多形性腺瘤各型。对不同组织类型和多项恶性指标及随访预后的关系进行对比和讨论。     

230例涎腺良、恶性多形性腺瘤临床病理研究

目的 探讨涎腺多形性腺瘤组织病理学的形态多形及术后高复发率的特征。方法 回顾性分析了230例涎腺良恶性多形性腺瘤临床病理资料,并对该肿瘤的术中快速切片的诊断进行分析。结果 良性多形性腺瘤224例,恶性多形性腺瘤6例,对良=恶生多形性腺瘤的类型,形态特点,诊断依据作了组织学研究。结论 按WHO推出的涎腺良、恶生多形性腺瘤的组织学分类。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。     

涎腺多形性腺瘤组织发生的探讨

采用钌红电镜组织化学技术对６例锶腺多殂性腺瘤进行研究，结果发现，粘液样区域内充满了钌红颗粒，在该区域肿瘤性肌上皮细胞浆内的分泌囊泡中也有钌红颗粒。于双层导管结构中，一些外周细胞也具有肌上皮细胞的特征，其细胞内和细胞外也见到钌红颗粒，导管上皮细胞不产生蛋白多糖，导管腔内的粘液不被钌红染色，观察结果表明，粘液样区域中的肿瘤性肿上皮细胞可能来自双层导管结构的外周细胞，它们分泌蛋白多糖形成粘液样区域，在我     

涎腺多形性腺瘤中Gli-2蛋白的表达及意义

目的 探讨转录因子Gli-2蛋白在涎腺多形性腺瘤(salivary pleomorphic adenoma,SPA)组织中的表达及其生物学意义.方法 采用免疫组织化学方法检测60例SPA组织中Gli-2蛋白的表达情况并进行分析.结果 Gli-2蛋白在60例SPA组织中高表达,主要表达在细胞核内,呈棕黄色颗粒.21例(3...     

野生型p53对涎腺多形性腺瘤细胞突变基因的修复

目的检测涎腺多形性腺瘤基因突变方式及野生型p53对突变基因的修复。方法留取4例涎腺多形性腺瘤新鲜标本，进行原代细胞培养。采用野生型p53基因转染培养细胞，通过逆转录聚合酶链反应检测转染后的基因表达。提取转染后各例细胞DNA及对应的肿瘤组织DNA，分别进行PCR反应扩增，聚丙烯酰胺凝胶电泳及核酸序列测定分析。结果PCR-单链构象多态性分析显示，3例出现异常电泳带。核酸序列测定结果显示，第6外显子的第203号密码子点突变；第8外显子的第272至290号密码子之间出现碱基缺失和碱基插入。野生型p53转染后的细胞DNA序列分析显示，p53第6和第8外显子的5个突变位点均恢复正常。结论涎腺多形性腺瘤发生过程中具有较高频率的p53基因突变，突变方式多样，涉及多个密码子；外源性野生型p53可有效地修复涎腺多形性腺瘤细胞中突变的p53基因位点。     

应用流式细胞术对涎腺多形性腺瘤恶性度的研究

采用流式细胞术对３８例涎腺多形性腺瘤进行ＤＮＡ含量和细胞增殖周期的检测。根据ＷＨＯ分类标准将本组肿瘤分为良性型（２７例）、低度恶性腺癌（０例）和恶性型（２例）。此外，尚有９例在形态学上不同于良性和恶性型，我们称之为交界型，此型上皮成分呈轻度非典型性。为了探讨肿瘤成分、基质比例与恶性度的关系，将良性型又分为三个亚型，即上皮成分为主型、粘液成分为主型和上皮粘液混合型。结果提示：良性型中各亚型ＤＮＡ指数     

涎腺恶性多形腺癌理学研究现状

本文综述了涎腺恶性多形性腺癌（MPA）的组织学类型，诊断标准，病理形态指标与预后的关系等有急议的问题，介绍了应用CEA，EMA多克隆免疫球蛋白抗体有助于鉴别良，恶性多性腺瘤及MPA与良性多形性腺瘤有类似的超微结构特征的概况。     

涎腺多形性腺瘤中赖氨酰氧化酶表达的研究

目的 检测涎腺多形性腺瘤(salivary pleomorphic adenoma,SPA)组织中赖氨酰氧化酶(lysyl oxidase,LOX)的表达,探讨LOX与SPA发生发展的关系.方法 取20例SPA组织标本,并配对20例SPA瘤旁涎腺组织,采用反转录聚合酶链式反应(RT-PCR)和实时荧光定量PCR方法检测LOX mRNA在组织中的的表达水平,并分析其表达变化,用蛋白质印迹法检测LOX的蛋白表达水平.结果 SPA组织中LOX mRNA表达水平明显高于瘤旁涎腺组织(12.81 ±0.92),SPA组织中LOX蛋白表达水平明显高于瘤旁涎腺组织.结论 LOX mRNA和蛋白在SPA瘤组织中均呈高表达,提示LOX的异常表达可能参与了SPA的发生、发展.     

涎腺多形性腺瘤98例临床分析

多形性腺瘤又名混合瘤。该瘤含有肿瘤上皮组织与粘液样组织或软骨样组织,因而其组织象具有多形性或混合性,故名多形性腺瘤或混合瘤。本文分析１９８５～１９９６年收集的９８例涎腺多形性腺瘤,全部病例均经病理证实。现报告如下：１　临床资料病例：本组病例中男性５２例,女性４６例。发病年龄：最小１８岁,最大６８岁。发病部位：腮腺７３例,颌下腺区１８例,硬腭２例,软硬腭处１例,舌部和唇部各２例。临床表现与诊断：本组９８例均以肿块而就诊,瘤体大小由于部位不同而差异。最小为０６ｃｍ直径（舌部）;最大为６ｃｍ×５ｃｍ…     

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。     

65例恶性成分为非特异性腺癌的涎腺恶性多形性腺瘤临床病理特点

目的 研究分析恶性成分为非特异性腺癌的涎腺恶性多形性腺瘤(malignant pleomorphic adenoma,MPA)的临床病理特点,以期为临床诊断和治疗提供参考.方法 回顾性分析115例原发MPA的临床病理资料,应用统计学软件分析恶性成分为非特异性腺癌和其他组织学类型病例在临床病理特点方面的差异,分析恶性成分为非特异性腺癌病例的临床病理指标与颈淋巴结转移的相关性.结果 恶性成分为非特异性腺癌的65例原发MPA中,男性58例,女性7例;发病年龄23～83岁,平均57岁,50～59岁最好发;发生于大涎腺61例,小涎腺4例;组织学分级为低、中、高度恶性者分别为12、14、39例;非侵袭性、微侵袭性、侵袭性MPA分别为15、13、37例;13例发生颈部淋巴结转移.恶性成分为非特异性腺癌的原发MPA组织学分级与侵袭性呈显著正相关(P＜0.05);侵袭性与TNM分期呈显著正相关(P＜0.05);侵袭性和组织学分级与颈部淋巴结转移之间有显著相关性(P＜0.05).结论 MPA恶性成分组织学类型最常见为非特异性腺癌,组织学分级越高,肿瘤的侵袭性越强;侵袭性癌、组织学分级高度恶性者易发生淋巴结转移.

Abstract：

Objective To analyze the clinicopathologic features of salivary malignant pleomorphic adenoma(MPA)(the subtype of the malignant component was classified as non-specific adenocarcinoma). Methods The clinical and pathological characteristics of 115 salivary gland tumors histologically diagnosed as MPA were analyzed. Results In all the 65 MPA cases, there were 58 male and 7 female patients, and the mean age was 57 years(from 23 to 83). Sixty-one tumors were located in major salivary glands, and 4 in minor. Histologically the malignant components of 39 tumors were high-grade, 14 intermediate-grade, and 12 low-grade. Thirty-seven tumors were invasive carcinoma, 13 minimally invasive, and 15 non-invasive. The high-grade tumors had positive correlation with the invasive carcinomas(P＜0.05). The invasive carcinomas had positive correlation with TNM clinical stage(P＜0.05). The invasive carcinoma and the high-grade tumor had correlation with cervical lymph node metastasis (P＜0.05).Conclusions Non-specific adenocarcinoma are the most common malignant subtype in MPA. The invasive and the high-grade types are more likely to metastasize to cervical lymph node.     

Product definition of pleomorphic adenoma of minor salivary glands

Thirteen cases of pleomorphic adenoma were studied by both immunohistochemical and other histochemical methods. The exocrine cells and myoepithelial cells appear to produce similar cell products as their normal salivary gland counterparts. Keratin was found in both exocrine cells and myoepithelial cells. CEA, secretory component, and lactoferrin were detected only in the tumor exocrine cells with adenoid differentiation. S-100 protein, ferritin, fibronectin, laminin and elastin were detected only in the myoepithelial cells. The residual sugars glucosyl, mannosyl, galactosyl and fucosyl were identified in both cell types, in variably detectable amounts.     

Product definition of pleomorphic adenoma of minor salivary glands

Thirteen cases of pleomorphic adenoma were studied by both immunohistochemical and other histochemical methods. The exocrine cells and myoepithelial cells appear to produce similar cell products as their normal salivary gland counterparts. Keratin was found in both exocrine cells and myoepithelial cells. CEA, secretory component, and lactoferrin were detected only in the tumor exocrine cells with adenoid differentiation S-100 protein, ferritin. fibronectin. laminin and elastin were detected only in the myoepithelial cells. The residual sugars glucosyl, mannosyl, Galactosyl and fucosyl were identified in both cell, types, in variably detectable amounts     

Myoepithelial carcinoma ex pleomorphic adenoma of salivary glands: a problematic diagnosis

We report the case of a 77-year-old woman who presented with a 6-year history of pleomorphic adenoma with multiple recurrences. Despite the clinical suspicion of a malignant process, the detection of myoepithelial carcinoma ex pleomorphic adenoma was not achieved by means of a preoperative biopsy or a frozen section removed intraoperatively, as the lesion only showed mild cytological atypia with no frank malignant features. Only a thorough evaluation of the resected tumor enabled the diagnosis of a malignancy. We discuss the difficulties that may be encountered in attempting to diagnose these rare myoepithelial lesions by means of small biopsy specimens.     

Pleo-morphic adenoma of the salivary glands: clinico-pathological study of 175 cases

In this report we analyzed 175 benign pleomorphic adenomas from the salivary glands. We described epidemiologic, clinical aspects and light microscopic features. We connected the sized, evolution time and their microscopically findings.     

Mucoepidermoid tumors of the intraoral minor salivary glands: A clinicopathologic study of 54 cases

Abstract. Clinical, gross and microscopic features of 54 mucoepidermoid tumors of intraoral minor salivary glands were studied. Thirty-four were further analyzed with regard to treatment and survival. Females predominated 2:1. The most common locations were palate, mandibular retromolar area and buccal mucosa. Mean duration was approximately 1 year, and most were asymptomatic. Fifty tumors were well-differentiated; four were poorly-differentiated. Growth pattern was generally infiltrative. Treatment was surgical in all cases. Mean follow-up duration was 47.1 months. Three well-differentiated tumors recurred once. One poorly-differentiated tumor recurred three times. No metastases or deaths occurred. Narrow or involved margins were common to recurrent but also to many non-recurrent tumors. Well-differentiated tumors behaved benignly and are best treated by modest local excision. Jaw resection is generally unnecessary. The practice of considering all mucoepidermoid tumors to be malignant is challenged.     

唾液腺多形性腺瘤恶变108例临床病理分析

目的:研究唾液腺多形性腺瘤恶变的临床病理特点。方法:回顾分析上海交通大学医学院附属第九人民医院口腔颌面外科1993年1月至2005年5月间唾液腺多形性腺瘤恶变病例的病理与临床资料。结果:108例唾液腺多形性腺瘤恶变病例,男68例,女40例,男女比为1.7∶1;年龄28～92岁,60～70岁最好发(29例),其次为50～60岁(22例)、70～80岁(20例)和40～50岁(19例)。发生于腮腺者68例,腭部20例,下颌下腺15例,其他部位包括唇、咽旁小唾液腺等。恶变成分主要为腺癌(26例),其次为肌上皮癌(19例),黏液表皮样癌(6例,包括低、中、高度恶性),腺样囊性癌(4例),其他有腺鳞癌、上皮-肌上皮癌、腺泡细胞癌、唾液腺导管癌、鳞癌等。5例发生颈部淋巴结转移,约占4.6%,其原发灶的恶变成分主要为腺癌。结论:唾液腺多形性腺瘤恶变多见于中老年男性,好发于腮腺,其次为下颌下腺和腭部,恶变成分多为腺癌和肌上皮癌;发生颈淋巴结转移者,恶变成分多为腺癌。     

复发性涎腺多形性腺瘤的临床与病理分析

目的 探讨复发性涎腺多形性腺瘤(recurrent pleomorphic adenoma,RPA)的临床与病理特点.方法 1962～2002年间在我院因涎腺RPA住院手术治疗的患者121例,对其中随诊10年以上的38例患者进行临床与病理分析.结果 腮腺、颌下腺及腭腺最多,复发次数分别为6、12、4次.单发14例,多发24例.腮腺及腭腺复发肿瘤除原手术野、手术切口瘢痕处外,6例多次复发后向腮腺深叶、咽旁及颅底扩展.34例中,病理类型以粘液成分为主型4例,细胞密集型13例,混合型17例.结论 结合病理研究,肿瘤复发的主要原因是残留瘤芽及术中肿瘤包膜破裂种植.复发肿瘤位置表浅、单发者可手术局部摘除,多发、位置深在者需行解剖面神经的肿瘤摘除术.避免涎腺多形性腺瘤术后复发的关键是第一次手术的术式,防止肿瘤包膜破裂并严格遵守无瘤手术原则.