耳鼻咽喉黏液表皮样癌的临床病理特征及鉴别诊断方法研究

Clinicopathological characteristics and differential diagnosis of mucoepidermoid carcinoma of ENT

目的研究并分析耳鼻咽喉黏液表皮样癌的临床病理特征,并对耳鼻咽喉黏液表皮样癌的鉴别诊断方法进行探讨。方法收集我院2005年1月~2016年12月期间共收治的120例耳鼻咽喉黏液表皮样癌病例资料进行回顾性研究分析,对其临床病理特点、X线、CT、超声、病理细胞学及病理组织学诊断结果进行分析。结果 120例耳鼻咽喉黏液表皮样癌的性别分布以男性为主,年龄分布以中老年人群为主。病理类型以高分化型为主,共110例,占91.67%,黏液细胞构成比重较高,表皮样细胞分化良好,核异形、核分裂极为少见,往往存在淋巴细胞浸润;低分化型黏液表皮样癌共10例,占8.33%,其黏液细胞构成比较低,通常低于10%,多由表皮样细胞或中间细胞构成,存在核异形、核分裂情况,且细胞浸润性较强。CT、超声对耳鼻咽喉黏液表皮样癌的阳性检出率高于X线,但不及病理细胞学、病理组织学,病理细胞学与病理组织学的诊断结果较为接近,需与腺样囊性瘤、多形性腺瘤进行鉴别诊断。结论耳鼻咽喉黏液表皮样癌多分布于中老年男性人群,病理类型多为高分化型,其病理类型不同,病理特征也不同,临床诊断时应结合临床病史、影像学检查结果、病理学检查结果进行综合诊断,并注意与腺样囊性瘤、多形性腺瘤进行鉴别区分。

Objective To study the clinical and patho- logical features of mucoepidermoid carcinoma of the ENT, and to discuss the differential diagnosis of the mucoepidermoid carcinoma. Methods 120 cases of Otolaryngeal mucoepi-dermoid carcinoma were enrolled in our hospital from January 2005 to December 2016 were analyzed retrospectively. For the Otolaryngeal mucoepidermoid carcinoma, the clinical and pathological features, the X-ray, the CT scanning, the ultra- sound, pathology, the cytology and the histopathology were analyzed. Results 120 cases of Otolaryngeal mucoepider- mold carcinoma were male dominated in the elderly population. The main pathological type is the well differentiated muco- epiderrnoid carcinoma with a total of 110 cases, accounting for 91.67%. Among them, there are heavy high differentiated mucoepidermoid carcinoma of the mucous cells, epidermis like cell differentiation, but the nuclear atypia and mitosis are extremely rare. And there are often lymphocytic infiltration. Poorly differentiated mucoepidermoid carcinoma were a total of 10 cases, accounting for 8.33%, which the mucous cells constitute a relatively low, usually less than 10%, mostly by epidermal like ceils or intermediate cells, the ex- istence of nuclear abnormity, nuclear division, and strong cell infiltration. CT scanning and ultrasound of Otolaryngeal mucoepidermoid carcinoma the positive rate was higher than that of X-ray, but lower than pathological cytology and histopathology. The Cytological and the histopathological diagnosis results are similar. Conclusion Otolarynge- al mucoepidermoid carcinoma in elderly male population distribution, pathological type is high differentiated, the pathological types and pathological features are also differ- ent, clinical diagnosis should be combined with clinical history, imaging findings, pathological results and com- prehensive diagnosis. Adenoid cystic tumor and pleomorphic adenoma need to be diagnosed differently.