6例口腔乳头状涎腺瘤的临床病理特点分析

Sialadenoma papilliferum:A clinicopathologic study of 6 cases

目的:探讨口腔乳头状涎腺瘤(Sialadenomapapilliferum,SP)的临床病理特点、病变性质、生物学行为及组织学发生。方法:对6例SP复片,观察其组织病理学特点,分析临床资料并随访,其中4例进行免疫组织化学染色,所用抗体为AE1/AE3、CK8、S-100、SMA、Vim、GFAP。结果:患者平均年龄64岁,男女之比为1∶1。临床无明显症状,肿瘤部位:舌缘3例,腭2例,舌根1例,肿瘤平均直径1cm。镜下见肿瘤无明显包膜,表面为口腔黏膜乳头状增生的复层鳞状上皮,其下肿瘤形成大小不等的管腔、囊腔样结构,部分管腔表面形成乳头状突起,管腔及乳头上皮被覆双层细胞。随访4例,均无复发及转移。免疫组化结果:表层细胞对AE1/AE3、CK8呈阳性表达,基底层细胞对S-100、AE1/AE3、SMA、Vim、GFAP呈阳性表达。结论:SP为良性肿瘤,组织学上以大小不等的管腔样结构内形成乳头为特征,预后良好,肿瘤可能来源于类似于分泌管的导管细胞。

PURPOSE:To study the clinicopathologic feature,nature,biological behavior and histogenesis of sialadeno-ma papilliferum(SP).METHODS:The clinicopathological features of6cases of SP were analyzed.Immunohistochemical staining was used in4cases,and the antibody used was AE1/AE3,CK8,S-100,SMA,Vim,GFAP.RESULTS:The average age of the patients was64years old,and the ratio of male to female was1:1.All of them were asymptomatic.Of the6cas-es,3on the margin of the tongue,2on the palate and1in the base of the tongue.The average diameter of the tumor was1cm.Microscopically,the tumor was lack of capsule.Superficially the squamous cells of oral mucosa proliferated to form multiple papillary extensions.Immediately subjacent to the papillary mucosa,the tumor was composed of cysts or duct-like structures with different sizes.The luminal surface of the ducts exhibited papilla projections.The ducts and their pap-illary folds were lined with a double layer of cells.Following-up information was obtained in4patients.No cases had re-currence and metastases.The Immunohistochemical results were AE1/AE3and CK8being positive in the cells of surface layer,and S-100,AE1/AE3,SMA,Vim and GFAP being positive in the cells of basal layer.CONCLUSIONS:Sialadeno-ma papilliferum was a benign neoplasm.Histologically,it is characterized as multiple papillary projections in cysts and duct-like structures.The prognosis of SP was good.It was most likely that SP arised from the duct cell resembling secre-tory ducts.