涎腺粘液表皮样癌的细胞病理学鉴别诊断

The cytopathological differential diagnosis of mucoepidermoid carcinoma

目的探讨涎腺粘液表皮样癌的细胞及间质成分的特征变化,提高与其他涎腺肿瘤鉴别的细胞学确诊率。方法采用细针吸取细胞学对46例有病理组织学结果的涎腺粘液表皮样癌细胞学诊断进行分析。结果46例粘液表皮样癌的细胞学诊断与病理组织学结果对照总符合40例(86.96%),高分化型粘液表皮样癌常易与多形性腺瘤相混淆。结论针吸细胞学对粘液表皮样癌的诊断具有较好的敏感性和可靠性,同时,粘液性状和瘤细胞排列分布的镜下表现常可作为粘液表皮样癌鉴别诊断的重要依据,对高分化型粘液表皮样癌在其细胞学表现与其生物学行为不相符时应予足够认识和积累经验。

Objective To investigate the cytological features of mucoepidermoid carcinoma of salivary glands. Methods Forty-six patients with mucoepidermoid carcinoma of salivary gland were diagnosed by fine needle aspiration cytology. Their cytological diagnositic results were compared with histopathologic findings. Results The total correspondence rate between cytological and pathological results was 86.96% （40 cases）, and the correspondence rate of classification of them was 82.61% （38 cases）. The oncocytes of well differentiated mucoepidermoid carcinoma were similar to those of pleomorphic adenoma. Conclusions Cytodiagnosis is an ideal method for clinical diagnosis of mucoepidermoid carcinoma as its higher sensitivity and reliability. The morphologic changes of mucus and cellular distribution shown under the microscope can be regarded as the important basis for distinguishing mucoepidermoid carcinoma. The cognitive ability and experience must be accumulated for the cytodiagnosis of mucoepidermoid carcinoma which oncocytes morphological changes are inconsistent with their biological behaviour.