食管原发性腺样囊性癌的临床病理分析

Clinicopathological analysis on primary adenoid cystic carcinoma of esophagus

目的 探讨食管腺样囊性癌（ACC）的临床病理特征、组织来源及预后。方法 应用HE染色、免疫组化及组织化学染色，对3例食管腺样囊性癌进行病理及临床分析。结果3例食管腺样囊性癌的癌组织主要由立方形腺上皮细胞和变异的肌上皮细胞组成，呈筛孔状腔隙、管状、实体状排列，腔隙内含嗜碱性和嗜伊红分泌物；3例食管腺样囊性癌中例1表面上皮有移行；免疫组化：3例CK、H-CK、P63、S-100（浆，核）、EMA、Bcl-2均（＋），例3CerBb-2（±），P53（＋），例2CD117（＋），AAT（±）、SMA（-），PAS／AB（＋）。结论 发生在食管的腺样囊性癌很少见，诊断标准及组织细胞起源建议严格定义，起源于唾腺的诊断腺样囊性癌，凡起源于其它部位或组织者应冠以腺样囊性癌。

Objective To study clinical pathologic features, tissue origin and prognosis of the adenoid cystic carcinoma （ACC） in the esophagus. Method Pathologic changes of 3 cases of ACC in the esophagus were studied by HE staining, immunohistochemical technique. Results The tissue of 3 cases of ACC in the esophagus was mainly composed of square shape gland epithelial cell and variant myoepithelial cell, mesh shape cavity crack and the tubular, the entity shape arrangement, the cavity crack content basophilia and acidophilia the secretion. There was transmigration of superficial epidermis in 1 case of ACC; All 3 cases were positive of CK, H-CK, P63, S-100 （endochylema/nucleus）, EMA, and Bcl-2. Case 3 was positive of CerbB-2 and P53. Case 2 was CD117 （＋）, AAT （＋）, SMA （-）, PAS/AB（＋）. Conclusions ACC is very rare in the esophagus, and it is suggested that diagnosis standard and the histological origin should be strictly defined. The origin from the salivary gland is diagnosed as adenoid cystic carcinoma, and origin from other places and tissues is named as adenoid cystic carcinoma type.