涎腺恶性肌上皮瘤的免疫组织化学研究

Immunohistochemical study of malignant myoepithelioma of salivary glangs.

目的 探讨涎腺恶性肌上皮瘤的临床病理特征及生物学行为。方法 采用组织病理学和免疫组化方法对 2 2例恶性肌上皮瘤进行分析。结果 好发于腮腺和腭腺 ;男性多见 (男女之比 2 3∶1) ;中位年龄4 9岁。病理特征为透明细胞型和上皮样细胞型多见 ,呈巢索状分布 ;细胞异型性明显 ,有病理性核分裂像 ;广泛浸润周围组织。免疫组化染色Actin、Ck 18、EGFR、TGFβ均呈明显的强阳性表达 ;PCNA阳性表达的平均增殖指数是 2 2 8%± 6 93,以透明细胞型的PI值为最高 ;癌基因C erbB 2、抑癌基因P53分别呈 63 6%和31 8%的阳性表达 ,各型的表达也以透明细胞型为最高。结论 恶性肌上皮瘤是一种上皮性肿瘤 ,其亚型透明细胞型恶性程度较高。C erbB 2、P53和PCNA的异常表达及协同作用在恶性肌上皮瘤的发生发展中起重要作用。

Objective TO study clinicopathologic characteristic and beharviour in malignant myoepithelioma of salivary glands.Methods 22 cases malignant myoepithelioma were examined by histopathological and immunohistochemical methods.Results The tumour arise most frequently within the parotid glands and palatine glands,sex distribution was men more than women,the median age was 49 years.The clear cell type and epithelial cell type of this tumour was mostly seen in the light microscope,with extensive invasion of the surrounding tissues.All cases showed the overexpression of Actin、Ck 18、EGFR、TGFβ.The average proliferation index(PI)of proliferating cell nuclear antigen(PCNA)in positive cells were 22.8% ±6.93,PI of clear cell type was the highest.The positive rates of c erbB 2 and p53 gene in 22 cases of the malignant myoepithelioma were 63.6%,31.8%,respectively.The cxpressions of clear cell type was also the highest.Conclusions The malignant myoepithelioma was epithelial tumour.The malignant grade of clear cell type was higher.The altered expression of oncogene c erbB 2 and antioncogenes p53 might play a promotive role in the tumorigenesis and development of malignant myoepithelioma.