黏膜表皮样癌31例临床病理分析

Clinical and Pathological Analysis of 31 Cases with Mucoepidermoid Carcinoma

目的探讨黏膜表皮样癌的临床和病理特征。方法通过对31例黏膜表皮样癌临床病理进行回顾性分析,结合文献进行讨论。结果显示不同性别肿瘤发病部位有差异,发生于大涎腺者及颌骨者男多于女,而发生于小涎腺者反之。大、小涎腺病变平均年龄分别为37.1和35.4岁。组织学特征,高分化(76.7%),以黏液细胞、透明细胞和分化好的表皮样细胞为主,细胞呈大片状、囊腔状或腺管状。异型性不明显,核分裂少见。低分化以分化差的表皮样细胞和中间型细胞为主,癌细胞呈小团块状或条索状排列。腺管样和囊腔样结构少见,癌巢中心常坏死,异型性明显,核分裂多见,呈浸润性生长。结论黏膜表皮样癌的病理分型对治疗方式有重要指导意义。

Objective To study the clinical and pathological character of mucoepidermoid carcinoma. Methods The clinicopathologic characteristics of 31 cases with mucoepidermoid carcinoma were analyzed retrospectively and reviewed of the literature. Results The tumor location was correlated with gender. Male gender was associated with mucoepidermoid carcinoma located in major salivamy gland and submaxillary, and female gender was associated with carcinoma located in minor salivamy gland. The average age located in major salivamy gland and minor salivary gland were 37.1 years old and 35.4 years old respectively which were lower than the mean age reported by Eveson. Morphologically, 76.7% of the tumor was well-differentlated, which arranged as patch, adenoid tubule or cystic cavity patterns consisting of mucous cells, clear cells and well-differentiated mucoepidermoid cells with unobvious atypia and rarely atypical mitosis. Poorly-differentiated tumor consisted of poorly-differentiated mucoepidermoid cells and intermediate cells, which arranged in interlacing bundles and mass （rarely as adenoid-tubule or cystic-cavity patterns） with common center necrosis, obvious atypia and invasive growth. Conclusions The pathologic grade of mucoepidermoid carcinoma is necessary in the selection of clinical treatment.