涎腺腺泡细胞癌临床病理分析

Analysis of the clinical pathologic acinar cell carcinoma of salivary gland

目的探讨涎腺腺泡细胞癌的临床特点、组织形态学特征、免疫组化特点、诊断、治疗及预后。方法复习15例涎腺腺泡细胞癌手术切除标本的病理切片,并进行免疫组织化学染色,结合相关临床资料进行分析。结果涎腺腺泡细胞癌各年龄段均可发病,好发于腮腺,生长缓慢,病程长,预后相对较好。涎腺腺泡细胞癌可见包膜,大部分肿物界限清楚,小部分肿物与周围组织粘连较紧,边界不清。组织形态学可见肿瘤细胞呈圆形,胞浆丰富,嗜碱性或透明,细胞核较小、深染,无明显异型性,排列成实性片状及腺泡状。免疫组织化学显示：CK阳性、S100部分病例阳性,β-catenin在73.3%的病例中存在异常表达,Ki-67阳性指数为5%-30%。结论涎腺腺泡细胞癌发病少,属低度恶性肿瘤,影像学诊断对其无特异性,主要依靠病理诊断来证实,治疗以根治性手术切除为主,术后可辅以放射治疗,以减少肿瘤复发及转移。

Objective To investigate the clinical characteristics of acinar cell carcinoma of the salivary glands, organization learning characteristics, immunohistochemical features, diagnosis, treatment and prognosis. Methods A total of 15 cases of salivary gland acinar cell carcinoma resection specimen pathological slices was reviewed and immunohisto- chemical staining, combined with relevant clinical data for analysis. Results All ages, the onset of salivary gland acinar cell carcinoma may occur in the parotid gland. The tumor growth slowly and had longer duration,however, the prognosis was relatively good. Salivary gland acinar celt carcinoma visible envelope, a clear majority of tumor boundaries, a small part of the tumor and surrounding tissue adhesion tight, ill-defined. Histologically, tumor cells were round visibility, abundant cytoplasm, basophilic or transparent, the nucleus was lesser, deeply stained, no atypia, arranged in solid sheets and alveolar. Immunohistochemical stains shown：CK-positive, S100 in some cases positive, β-catenin expres- sion in abnormal in 73.3% of cases, Ki-67 positive index of 5% to 30%. Conclusion Acinar cell carcinoma of salivary gland diseases , is a low-grade malignant tumor, imaging diagnosis for its specificity, rely mainly on pathological diag- nosis to confirm, radical resection is main treatment. After surgery can be supplemented by postoperative radiotherapy, in order to reduce the tumor recurrence and metastasis.