复发性泪腺多形性腺瘤临床特征分析及相关凋亡因子研究

Clinical feature analysis and correlated apoptosis factors study of recurrent lacrimal gland pleomorphic adenomas

目的对复发性多形性腺瘤的临床特征等进行分析并对其表达的相关凋亡因子survivin和caspase-3进行研究。方法收集2003年1月至2007年1月期间住院的泪腺多形性腺瘤、复发性多形性腺瘤及腺样囊性癌患者的临床资料，对这些患者术后的石蜡包埋标本进行survivin和caspase-3免疫组化染色。结果复发性多形性腺瘤多表现眶壁骨质破坏及边界不规则的特点；survivin表达方面，复发性多形性腺瘤与初次手术的多形性腺瘤之间差异有统计学意义（P〈0．05），而与腺样囊性癌之间差异则无统计学意义（P〉0．05）；caspase-3表达方面，各组之间差异无统计学意义（P〉0．05）；Survivin与caspase-3之间呈负相关（r=-0．995，P〈0．05）。结论复发性泪腺多形性腺瘤虽然在病理上表现为良性，但在生物学行为上则是恶性肿瘤的表现，治疗上应多从该肿瘤的恶性生物学行为方面进行考虑；survivin的高表达与caspase-3的低表达可能在泪腺多形性腺瘤的复发中具有重要作用。

Objective To analyze clinical features of recurrent lacrimal gland pleomorphic adenoma and study correlated apoptosis factors-survivin and caspase-3. Methods It was a retrospective case series. Clinical data of lacrimal gland pleomorphic adenomas, recurrent pleomorphic adenomas and adenoid cystic carcinomas were collected from January 2003 to January 2007. All these surgical specimens were studied with immunohistochemical staining of survivin and caspase-3. Results Most recurrent pleomorphie adenomas displayed destruction of orbital wall and irregular boundary. There were statistically significant differences between recurrent pleomorphic adenomas and pleomorphic adenomas （P 〈0.05） while no statistically significant differences between recurrent pleomorphie adenomas and adenoid cystic carcinomas （P 〉0.05） in expression of survivin. And there were no statistically significant differences in expression of caspase-3 （P 〉0.05）. The expression of survivin was negatively correlated with caspase-3 （r =-0.995, P 〈0.05）. Conclusions Although the recurrent lacrimal gland pleomorphic adenomas are benign in pathology, they display malignant tumors in biological behaviors. We should consider their malignant biological behaviors in the therapy. Both over expression of survivin and descended expression of caspase-3 may play an important role in recurrence of pleomorphic adenomas.