涎腺恶性淋巴上皮病损的临床病理研究

涎腺恶性淋巴上皮病损是涎腺罕见的恶性肿瘤之一，具有明显的种族特性。本文对２７例恶性淋巴上皮病损进行了临床病理学分析和随访调查，探讨肿瘤生物学行为有关的病理因素，发现间质中纤维结缔组织多，玻璃样变明显者预后较差，本文还着重对ＭＬＥＬ的命名、诊断、鉴别诊断、病理组织学与预后的关系进行了讨论。     

大涎腺淋巴上皮病的临床分析

目的:探讨淋巴上皮病(lymphoepitheliallesion,LEL)流行病学特点以提高临床诊断准确率。方法:对19例淋巴上皮病病例的年龄、性别、病理类型、病程、临床和影像学表现、实验室检查结果、诊断情况进行回顾性分析。结果:淋巴上皮病发病年龄多在40～50岁左右,无性别差异。主要表现为局限性肿块或涎腺弥漫性肿大。肿块界清,直径0.6～4.6cm不等,活动度尚可,多数位于耳垂周围,良性者质地中等,恶性者质地较硬。一般无自发痛及面神经功能障碍,少数有轻压痛。无眼干、口干及关节疼痛等症状。淋巴上皮病可累及双侧腺体,绝大多数发生于大涎腺,腮腺最常见,且常呈多病灶。该病患者血清球蛋白往往升高,白球比下降。结论:淋巴上皮病的临床表现有一定规律性,结合影像学表现和实验室检查,可提高诊断率。     

腮腺良性淋巴上皮病临床及病理研究

目的　观察腮腺良性淋巴上皮病 (BLEL)病理及临床特征。方法　收集 13例腮腺BLEL临床及病理资料 ,利用苏木精 -伊红染色 ,CD45R0 、CD45以及CD2 0 等免疫组化标记观察。结果　腮腺BLEL组织学表现为大量淋巴样细胞弥散浸润腺体间质 ,上皮 -肌上皮岛形成并取代腺泡和腺体结构 ,免疫组化证实其大多数为B系淋巴细胞。结论　腮腺BLEL可能是腺体长期炎症影响的结果 ,在其基础上可以引发B系、结节外低度恶性淋巴瘤。手术辅以放疗 ,可获较好疗效。     

口腔颌面部恶性肿瘤病人可溶性白介素2受体的检测

本试验采用ELLSA法检测了60例口腔颌面部恶性肿瘤病人，21例口腔颌面部良性肿瘤病人，30例正常人的sIL－2R水平。结果：恶性肿瘤病人sIL－ZR水平较良性肿瘤病人较正常人水平明显升高（P＜0．001），良性肿瘤病人与正常人间无差异（P＞0.05），且sIL－2R水平与病理分级及临床分期有关。sIL－2R作为监视机体免疫状态的一种指标可帮助诊断分析、病情监测及预后评估。     

Lymphoepithelial carcinoma in the sublingual gland

Lymphoepithelial carcinoma is rare in the salivary glands, with an incidence of 0.4%. The most commonly affected site is the parotid gland, followed by the submandibular gland. Lymphoepithelial carcinoma in the sublingual gland has been reported only four times in the existing English-language literature. Such tumours are characterized by the presence of a poorly differentiated carcinoma that is surrounded and infiltrated by lymphocytes, and they are strongly associated with Epstein–Barr virus infection, patient ethnicity, and prominent radiosensitivity. Wide surgical excision combined with adjuvant therapy has been suggested as the first-choice therapeutic regimen. This report describes the case of a 34-year-old Indonesian woman who was evaluated and treated in Taipei Medical University Hospital. She had a tumour that presented as a painless swelling on the floor of the mouth. The diagnosis was confirmed by conducting an incisional biopsy, and a wide surgical excision with bilateral supraomohyoid neck dissection and free flap reconstruction was performed. The patient also underwent adjuvant chemoradiotherapy. No evidence of local recurrence or distant metastasis was detected during the 6 months of follow-up. Subsequently, the patient returned to her home country, and further follow-ups were not conducted.     

Evaluation on Malignant Transformation of Oral Lichen Planus

目的：口腔扁平苔藓（oral lichen planus,OLP)是否属于癌前病变,至今仍存在较大的争论。本文的目的在于评估OLP的癌变性质。方法：报告1995－2002年之间9例OLP的癌变病例。结果：5例OLP患者同时或继发为口腔鳞状细胞癌,1例为疣状癌,3例为上皮异常增生。其中7例发生在原OLP存在的部位,1例发生在其它部位,1例在同一部位同时存在OLP和鳞状细胞癌。OLP的癌变常发生在糜烂型和萎缩型,发生于颊粘膜,舌或牙龈。根据所制定的OLP的诊断及癌变标准,4例OLP患者发生了癌变。结论：OLP具有一定的癌变潜力,对OLP患者应每年随访2－4次,尤其是对发生在颊粘膜,舌或牙龈的糜烂型和萎缩型的患者。     

口腔粘膜癌前病变患者细胞DNA修复功能的检测

目的:探讨口腔粘膜癌前病变患者DNA修复水平的变化。方法:采用宿主细胞再活化反应性检测癌前病变组和正常对照组的16对配对病例,同时对吸烟、饮酒、家族史三项重要危险因素进行调查分析。结果:癌前病变患者细胞再活化反应性显著低于正常对照组(P<0105),该项指标在癌前病变发生中属重要危险因素,OR为3125 (95%CI=1101~10149)。结论:宿主细胞再活化反应性可用于临床辅助判断癌前病变预后和针对性监控的指标。     

Periodontal Treatment Combined With Tongue Cleaning Reduces Oral Malodor Among Patients With Periodontitis, Whereas for Patients With Gingivitis, Tongue Cleaning Alone is Sufficient

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Clinical trial of oral malodor treatment in patients with periodontal diseases. Pham TA, Ueno M, Zaitsu T, Takehara S, Shinada K, Lam PH, Kawaguchi Y. J Periodontal Res 2011;46:722-9. REVIEWERS: Khady Ka, DDS, MSc, and Belinda Nicolau, DDS, PhD PURPOSE/QUESTION: To what extent do periodontal treatment and tongue cleaning reduce oral malodor among patients with periodontitis and patients with gingivitis? SOURCE OF FUNDING: Information not available TYPE OF STUDY/DESIGN: Randomized controlled trial LEVEL OF EVIDENCE: Level 2: Limited-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE: Not applicable.     

Chronic Periodontitis Is Associated With Spinal Dysmobility in Patients With Ankylosing Spondylitis

Background: Although microbes have been suggested to play a role in the pathogenesis of ankylosing spondylitis (AS), several studies present contradictory results regarding the association between AS and chronic periodontitis (CP). Methods: Clinical, laboratory, and medication data were collected from 84 patients with AS and 84 age‐ and sex‐matched controls. Periodontal measurements, including probing depths (PDs), clinical attachment loss (AL), serum anti‐Porphyromonas gingivalis titers, and the detection of P. gingivalis DNA in gingival crevicular fluid, were recorded. All participants with periodontitis with PD ≥4 to <7 mm received scaling and root planing and were re‐evaluated at 12 weeks; those still exhibiting periodontitis with PD of ≥4 to <7 mm at 12 weeks were followed at 24 weeks. Results: The prevalence of moderate‐to‐severe CP was not different between patients with AS and controls (70.2% versus 66.6%). The P. gingivalis detection rate was not different between patients with AS and controls or between patients with AS receiving and not receiving anti–tumor necrosis factor (TNF)‐α agents. However, CP was positively associated with impaired spinal mobility of patients with AS in multivariate analyses. After periodontal treatment, PD and AL levels were improved in both groups, but the change was significantly greater in patients with AS than in controls. Patients with AS receiving anti‐TNF‐α agents exhibited a greater improvement in PD and AL than those who did not. Conclusions: Although AS was not associated with the presence of CP, CP was associated positively with the severity of spinal dysmobility in Korean patients with AS. These results suggest that periodontitis can have a negative effect on axial movement in AS.     

腮腺区淋巴上皮囊肿1例报道

<正>淋巴上皮囊肿,又名良性淋巴上皮囊肿,临床较少见。可发生于腮腺、口底及腭扁桃体等颌面部各个部位,但副腮腺区淋巴上皮囊肿尚未见报道。我们收治了1例左侧腮腺区淋巴上皮囊肿,现报道如下。     

Salivary Visfatin Concentrations in Patients With Chronic Periodontitis

Background: Visfatin, also known as pre‐B‐cell colony‐enhancing factor, is secreted from a variety of cells and is thought to have some proinflammatory and immunomodulating effects. It is indicated that serum/plasma levels of visfatin increase in a number of inflammatory disorders. The present study aims to evaluate salivary concentrations of visfatin in patients with chronic periodontitis (CP). Methods: Twenty patients with CP and 20 periodontally healthy individuals were enrolled in this study. For each patient, the values of clinical parameters, such as bleeding index, plaque index, probing depth, and clinical attachment level (CAL), were recorded. Whole saliva samples were collected, and concentrations of visfatin were evaluated using standard enzyme‐linked immunosorbent assay. Statistical analysis was performed using statistical software. Results: Visfatin was detectable in all samples. Salivary visfatin concentrations were significantly higher in the periodontitis group. In addition, there was a positive significant relationship between salivary visfatin concentrations and CAL in the periodontitis group. However, no significant association was observed between salivary visfatin levels and other periodontal parameters or body mass index. Conclusion: These results indicate that there is a relationship between salivary visfatin and CP; however, further studies are needed to confirm this finding.