涎腺腺样囊性癌和基底细胞腺瘤的免疫表型及临床病理特征

Clinicopathological characteristic and immuniohistochemical staining of the adenoid cystic carcinoma and basal cell adenoma in salivary gland

目的观察CK7、Calponin、CD117、Ki-67在涎腺腺样囊性癌(adenoid cystic carcinoma,ACC)和基底细胞腺瘤(basal celladenoma,BCA)中的免疫表型及其病理组织形态学差异,以提高对该类肿瘤鉴别诊断的认识。方法对发生于涎腺的26例BCA和17例ACC进行临床和病理组织形态观察并免疫组化标记(CK7、Calponin、CD117、Ki-67)。结果临床特点为两种肿瘤的发病年龄相似,但发生部位不同,ACC好发于腮腺以外的小涎腺,BCA多数发生于腮腺;病理特点为前者表现为浸润性生长并累及周围组织;免疫组化显示两种肿瘤存在免疫表型差异:其中CD117在ACC和BCA之间的强阳性率差异有统计学意义(P<0.05);Ki-67在BCA和ACC之间的强阳性率差异有统计学意义(P<0.01)。结论 ACC具有浸润性生长的生物学特征,病理特点上与BCA鉴别主要基于两者的生长方式和组织形态学检查,CD117和Ki-67免疫组化标记有助于其鉴别诊断。

Purpose To study the morphological characteristics and immunophenotype of adenoid cystic carcinoma （ACC） and basal cell adenoma （BCA） in salivary gland, and to improve the level of diagnosis and differential diagnosis. Methods 17 cases of ACC and 26 cases of BCA were observed respectively with their clinical findings, histopathology and immunohistochemical staining for CK7, Calponin,CDll7 and Ki-67. Results Parotid gland was predilection site of BCA, whereas others salivary glands except parotid gland were predilection sites of ACC. The immunophenotype had some differences in two groups： immunohistochemical expression of CD117 in groups of ACC and BCA had statistical significance （ P 〈 0.05 ） , expression of Ki-67 in groups of BCA and ACC had statistical sig- nificance （ P 〈 0.01 ）. Conclusions The diagnosis and differential diagnosis of ACC and BCA were based on their growth patterns and morphological characteristics. The immunohistochemical staining of CDll7 and Ki-67 may contribute to differentical diagnosis.