涎腺肌上皮瘤与多形性腺瘤的免疫组化研究

An Immunohistochemical Study of Myoepithelioma and Pleomorphic Adenoma of Salivary Gland

采用抗平滑肌的肌动蛋白（ａｃｔｉｎ）、肌球蛋白（ｍｙｏｓｉｎ）；Ｓ－１００蛋白以及胶质纤维酸性蛋白（ＧＦＡＰ）抗体研究涎腺肌上皮瘤和多形性腺瘤。结果发现，肌上皮瘤细胞对上述４种抗体呈不同程度的阳性反应。在多形性腺瘤中，双层导管结构的外周瘤细胞，成片增生的梭形细胞以及粘液样区域内的星形、三角形瘤细胞对上述４种抗体反应阳性，鳞状化生的瘤细胞也反应阳性，导管内层瘤细胞对上述４对抗体反应阴性。本文研究结果表明：①在多形性腺瘤中，肿瘤性肌上皮细胞可以出现鳞状化生，可以通过鳞状化生形成鳞状细胞癌，成为恶性多形性腺瘤中鳞状细胞癌的组织来源；②肌上皮瘤和多形性腺瘤中肿瘤性肌上皮细胞具有相同的免疫特性和分化趋向，用上述抗体不能鉴别这两种肿瘤。

Abstract Twelve pleomorphic adenomas and eight myoepitheliomas were studied by an immunohistochemistry with antiactin,myosin, S-100 protein and glial fibrillary acidic protein(GFAP) antibodies. The results indicated that in pleomorphic adenoma, actin, myosin, S-100 protein and GFAP expression were seen in the stellate, triangle cells in the myxoid region and in the basal layer cells of the double-layered duct structure, these tumor cells were regarded as neoplastic myoepithelial cells,the squamous metaplasia cells were positive in the tumors; myoepithelioma cells were identified by weak to intense actin, myosin, S-100 protein and GFAP positive reaction. This fact suggested that (1) in pleomorphic adenoma, neoplastic myoepithelial cells could transform into the squamous metaplasia cells, if malignant changes occur, they will become squamous cell carcinoma by squamous metaplasis;(2) neoplastic myoepithelial cells of pleomorphic adenoma were the same immunofeature as myoepithelioma cells, more than 5%～10% of ductal components of pleomorphic adenoma is principle differential from pleomorphic adenoma and myoepithelioma.