口腔颗粒细胞瘤14例临床病理分析

目的 回顾性分析14例口腔颗粒细胞瘤(OGCT)的临床特征并行组织学分型及增殖活性检测。方法 收集1970至2003年武汉大学口腔医学院口腔病理科OGCT存档资料14例，分析其临床及组织病理学特征并随访，应用免疫组化方法行S-100、NSE及Ki-67染色。结果 OGCT好发于舌部(13／14)，患者平均年龄32．6岁(年龄范围11～50岁)。男：女为1：2．5。镜下观察所有肿瘤由多边形瘤细胞组成，胞质中有丰富的嗜酸性颗粒，且S-100及NSE染色阳性。14例OGCT中11例良性，3例细胞不典型性。3例良性OGCT呈膨胀性生长，其余8例良性及3例细胞不典型性病例均为侵袭性生长。少数肿瘤细胞Ki-67染色阳性。随访的10例中1例肿瘤细胞明显呈不典型性者复发并死亡，9例无复发。结论 大多数OGCT为良性，极少数具有潜在恶性，应注意随访。少数肿瘤细胞Ki-67阳性提示该肿瘤具有较低的增殖活性。

A clinicopathological study of 14 cases of oral granular cell tumor

OBJECTIVE: To describe clinical and histological features of oral granular cell tumor (OGCT)and discuss their proliferative activity. METHODS: Clinical and microscopic features were assessed in 14 cases of OGCT collected from the department of oral pathology, college of stomatology of Wuhan University between 1970 and 2003. Immunohistochemical analysis was carried out using antibodies to S-100, NSE and Ki-67 and follow-up was obtained in all cases. RESULTS: Tongue was the most commonly affected location (13/14). The average age was 32.6 years (range 11 to 50). OGCT occurred more commonly in females (2.5:1). Histologically, the lesions consisted of polygonal cells with abundant, granular cytoplasm. Eleven cases had typical histological features, while 3 specimens were atypical. Growth patterns were expansive in 3/14 and invasive in 11/14, including 3 atypical cases. Immunohistochemical analysis disclosed that 100% of granular cells demonstrated moderated/strong staining for S-100 protein, neuron specific enolase (NSE). Nuclear immunostaining for Ki-67 was observed only in isolated granular cells. Seven patients with benign and two patients with atypical granular cell tumor had no recurrence and metastases. One patient with atypical granular cell tumor had local recurrence after 9 years and died of the disease 10 months later. CONCLUSIONS: OGCT cells display low proliferation activity. Most OGCTs are benign but few have malignant potential and periodic follow-up is mandatory to detect malignant transformation.