涎腺导管癌临床及病理学特点的研究

Study about the clinical and pathological characteristics of salivary duct carcinoma

目的探讨涎腺导管癌(SDC)临床及病理学特点,为临床诊断和治疗提供依据。方法对昆明医学院附属口腔医院2001年3月—2009年2月收治的8例SDC患者进行临床资料回顾分析,并用免疫组织化学方法检测SDC组织中血管内皮生长因子(VEGF)、细胞角蛋白(CK)、巨囊性病液体蛋白(GCDFP)-15、雄激素受体(AR)、癌基因C-erBb-2的表达情况。结果SDC好发于腮腺,术前多有面瘫表现,复发3例。计算机断层扫描示界限不清,可伴有类结晶形成。VEGF、CK、GCDFP-15及C-erBb-2均呈阳性表达,多数病例AR呈阳性表达。结论SDC是一类恶性程度很高的涎腺肿瘤,类似乳腺导管癌。GCDFP-15、AR及C-erBb-2对SDC的病理学诊断有较重要的参考价值。

Objective To investigate the clinical and pathological characteristics of salivary duct carcinoma（SDC） so as to provide basis for the diagnosis and therapy of SDC. Methods Eight patients suffered with SDC treated in Affiliated Stomatological Hospital of Kunming Medical College from March 2001 to February 2009 were studied retrospectively including the clinical data. Meanwhile, eight tumor specimens were examined for vascular endothelial growth factor（VEGF）, cytokeratin（CK）, gross cystic disease fluid protein（GCDFP）-15, androgen receptor（AR）and oncogene C -erBb -2 protein expression via immunohistochemistry. Results Of the eight patients with SDC, five tumors grew in the parotid gland, the majority of the patients had facial nerve paralysis, three had recurrence. Computerized tomography（CT） showed that no obvious margin and similar crystal. Immunohistochemical staining for the expression of VEGF, CK, GCDFP -15 and C -erbB -2 were carried out in all SDC, while AR in majority. Conclusion SDC is a high-grade malignant carcinoma among all salivary carcinoma, immunohistochemical analysis of SDC has revealed a variety of similarities to ductal carcinoma of the breast. GCDFP-15, AR and C-erBb-2 may play an important role in pathological diagnosis for SDC.