腺样囊性癌中CD117的表达及其与临床病理关系

Analysis of overexpression of CD117 in adenoid cystic carcinoma and the relationship between its expression and clinic behavior

目的观察CD117在腺样囊性癌(adenoid cystic carcinoma,ACC)中的表达与临床病理改变的相关性。方法对68例ACC患者进行临床病理资料总结、分析,采用免疫组化EnVision法检测CD117的表达。结果男性33例,女性35例。平均年龄46.8岁。癌组织位于眼眶21例,鼻腔鼻窦23例,其它部位24例。患者5年生存率为75.92%,10年生存率为11.61%。组织学形态多以筛状及管状结构为主。49例可见神经、脉管或骨侵犯。组织学形态是预后的独立因素(P=0.036)。CD117在92.6%ACC的腺上皮中有不同程度的表达,与预后无明显相关性(P=0.451);CD117在42.6%ACC的肌上皮中有不同程度的表达,与组织学分级相关(P=0.021),与预后无直接相关(P=0.133)。结论 ACC患者的5年预后较好,10年生存率明显降低。CD117在肌上皮中过度表达与组织学分级相关,间接提示ACC预后不良。

Purpose To observe the clinicopathological features of adenoid cystic carcinoma and the relationship between CD117 ex- pression and prognosis. Methods The clinical materials were collected and analyzed. The histopathologic features were observed. CD117 expression was detected by immunohistochemical technique. Results 33 males and 35 females were retrieved with an average age of 46. 8 years. The tumor involved fossa orbitalis （21）, nasal cavity and accessory sinuses （23）, and other sites （24）. Five years and ten years survival was 75.92% and 11.61%, respectively. Tubular and cribriform pattern were most common. Perineural, vascu- lar and bone invasion were present in 49 cases. Histological pattern was the independent factor of prognosis （P = 0. 036）. CD117 was overexpressed in glandular epithelia in 92. 6% cases and wash＇ t related to prognosis （P = 0. 451 ）. CD117 was overexpressed in myo- epithelium in 42. 6% cases and was related to histological pattern （P = 0. 021 ）. Conclusions ACC has a better 5-years survival and a poor 10-years survival. CD117 overexpression in myoepithelia is related to histological grading and may indirectly suggest poor prog- nosis.