Quantitative Study on Expression of P16 Multiple Tumor Suppressor Gene in Salivary Gland Neoplasm

The expression of P16 gene were found in all 3 groups. The positive unit (PU) was higher in tumor group and cancer group than that in normal group ( P <0.01). Furthermore, the PU of P16 was stronger in cytoplasm than in nucleus. Malignant tumors and acini surrounding the tumor revealed strong positives and week positives respectively. The PU of P16 gene was higher in deep lobe of recurrent parotid neoplasm with incomplete capsule than that in shallow lobe of primary parotid neoplasm with complete capsule. Our findings suggests that P16 gene plays equally important role in the salivary gland tumors and tumors in other part of the body.

Postoperative radiotherapy for thymus salivary gland carcinoma:A case report

BACKGROUND Salivary gland cancer is a rare disease in which cancer cells form in the tissues of the salivary glands.It mostly occurs in the glands that have secretion functions,such as the parotid gland,sublingual gland and submandibular gland.This is very rare when it occurs in other nonsecreting glands.Here,we report one case of salivary gland carcinoma occurring in the thymus and discuss related diagnoses and treatment progress.CASE SUMMARY One 33-year-old middle-aged man presented with a thymus mass without any clinical symptoms when he underwent regular physical examination.Later,the patient was admitted to the hospital for further examination.Computed tomography(CT)showed that there was a mass of 3 cm×2.8 cm×1.5 cm in the thymus area.The patient had no symptom of discomfort or tumor-related medical history before.After completing the preoperative examinations,it was confirmed that the patient had indications for surgery.The surgeon performed a transthoracoscope"thymectomy+pleural mucostomy"for him.During the operation,the tumor tissue was quickly frozen,and the symptomatic section showed a malignant tumor.The final pathological result suggested thymus salivary gland carcinoma-mucoepidermoid carcinoma(MEC).In the second month after surgery,we performed local area radiotherapy for the patient,with a total radiation dose of 50.4 Gy/28Fx.After 12 mo of surgery,the patient underwent positron emission tomography-CT examination,which indicated that there was no sign of tumor recurrence or metastasis.After 16 mo of operation,CT scan re-examination showed that there was no sign of tumor recurrence or metastasis.As of the time of publication,the patient was followed up for one and a half years.He had no sign of tumor recurrence and continued to survive.CONCLUSION The incidence of MEC in the thymus is low,and its diagnosis needs to be combined with clinical features and imaging methods.Histopathological analysis plays a key role in the diagnosis of the disease.Patients with early-stage disease have a good prognosis and long survival period.In contrast,patients with advanced-stage disease have a poor prognosis and short survival period.Combining radiotherapy and chemotherapy in inoperable patients may prolong survival.

Selective partial salivary glands sparing during intensity-modulated radiation therapy for nasopharyngeal carcinoma

Objective This study evaluated the dosimetric consequences of selective partial salivary gland sparing during intensity-modulated radiotherapy(IMRT) for patients with nasopharyngeal carcinoma(NPC).Methods Ten patients with NPC were enrolled in the study.Two IMRT plans were produced for each patient:conventional(control) and partial salivary glands-sparing(treatment),with dose constraints to the entire parotid glands or partial salivary glands(including the parotid and submandibular glands,delineated with the adjacent distance of at least 0.5 cm between the glands and PTV,the planning target volume) in planning,respectively.Dosimetric parameters were compared between the two plans,including the V_(110%),V_(100%),V_(95%)(the volume covered by more than 110%,100%,or 95% of the prescribed dose),Dmin(the minimum dose) of PTV,homogeneity index(HI),conformity index(CI),and the mean dose and percentage of the volume receiving 30 Gy or more(V_(30)) for the parotid glands and submandibular glands.Results Treatment plans had significantly lower mean doses and V_(30) to both the entire parotid glands and partial parotid glands than those in control plans.The mean doses to the partial submandibular glands were also significantly lower in treatment plans than in control plans.The PTV coverage was comparable between the two plans,as indicated by V_(100%),V_(95%),Dmin,CI,and HI.The doses to critical structures,including brainstem and spinal cord,were slightly but not significantly higher in treatment plans than in control plans.Conclusion A selective partial salivary gland-sparing approach reduces the doses to parotid and submandibular glands during IMRT,which may decrease the risk of post-radiation xerostomia while not compromising target dose coverage in patients with NPC.

30-bp DELETION IN LATENT MEMBRANE PROTEIN 1 (LMP-1) ONCOGENE IN LYMPHOEPITHELIAL CARCINOMA OF SALIVARY GLANDS

Objective: To investigate the 30 bp deletion in LMP-1 in lymphoepithelial carcinoma of salivary glands, and to clarify the deletion rate. Methods: 46 cases of LEC were subjected to PCR examination for the 3?terminal region of LMP-1 gene, in order to observe the 30 bp deletion. To reduce the influence of unsuccessful DNA extraction from paraffin-embedded tissue sections, a bactin PCR was performed at the same time. Additionally, DNA sequencing was performed on 1 case without deletion and 1 case with deletion. Results: 4 of 46 specimens were proved to contain no suitable DNA sample by bactin gene amplification. In the remaining 42 cases, LMP-1 DNA was detected in 35/42 (83.3%) LEC cases. Two kinds of PCR products were found in these 35 cases after further DNA sequencing. 31 cases (88.6%) carried 316 bp product and 4 cases (11.4%) carried 286 bp product. Conclusion: Some LECs of salivary glands carry del-LMP-1. In our study, the deletion rate was 11.4% (4/35).

The impact of interval between surgery and postoperative radiotherapy in major salivary gland carcinoma

Background:Radiotherapy following primary operation is strongly recommended for salivary gland carcinomas(SGCs)with adverse features.The interval between surgery and the initiation of radiotherapy(SRT)varied and a prolonged SRT may cause failure of cancer treatment.However,the association of SRT with survival is unclear in major SGCs.Methods:This retrospective study included a total of 346 patients who underwent radiotherapy after the pri-mary operation from Fudan University Shanghai Cancer Center from 2005 to 2020.The best cutoffvalue of the SRT was determined by the maximum log-rank statistic method.The primary endpoint of the study was over-all survival(OS).Correlations between variables and OS were conducted by the univariable analysis using the Log-rank method,and a multivariate Cox proportional hazards regression was performed to identify the indepen-dent prognostic factors associated with OS.The estimated survival rates were captured using the Kaplan-Meier method.Results:With a median follow-up time of 70.31 months,the estimated 5-year OS,LRFS,and DMFS were 83.3%,80.1%,and 75.9%,respectively.The cutoffvalue for SRT was 8.5 weeks,while age,T stage,N stage,perineural invasion(PNI),pathological aggression,chemotherapy,and SRT were associated with OS in the univariable analysis.The Cox regression analysis demonstrated that older age(P<0.001),T3-4 tumors(P=0.007),positive N stage(P<0.001),pathological aggression(P=0.014),and longer SRT(P=0.009)were independent prognostic factors for major SGCs.Using the stratification model,we observed that delay in the SRT was associated with worse OS(P=0.006)in the high-risk group,whereas no significant difference was observed in the low-risk subgroup(P=0.61).Conclusions:The delay in the initiation of postoperative radiotherapy may be a prognostic factor for patients with major SGCs.It was suggested that radiotherapy should be delivered within 8.5 weeks following the operation,especially for patients with≥2 risk factors,including older age,high pathological aggression,T3-4 tumors,and positive N stage.

Hamartomatous Polyp of Minor Salivary Gland Arising in the Tongue: A Report of the First Case

Benign tumorous condition can be encountered at very unusual location in oral cavity and pharyngeal region, which leads diagnostic difficulty. Here we describe a very unusual presentation of polypoid hamartoma on the root of the tongue. A 59-year-old woman presented with a polypoid tumor mass on the dorsal root of the tongue. Microscopically, it was hamartoma showing normal salivary glands of mucinous and serous types, lymphoid hyperplasia, and skeletal muscle bundles. Major differential diagnoses include accessory tongue, adenomatoid hyperplasia, and idiopathic hyperplasia of sublingual glands. To our knowledge, this is the first report of hamartoma arising in the root of the tongue presenting as polypoid mass. Correct diagnosis based on pathologic examination is essential for proper treatment.

Cribriform Adenocarcinoma Salivary Gland-Type of the Nasopharynx: Case Report and Review of the Literature

Primary salivary gland-type carcinoma of the nasopharynx is a rare malignancy with aggressive clinical behavior and poor prognosis. Few cases have been reported in the literature. We report the case of a salivary gland-type carcinoma of the nasopharynx diagnosed in a 70-year-old woman managed in department of radiotherapy at Hassan II University Hospital in Morocco. The patient received a total of 70 Gy of radiations, which were divided into 2 Gy per session during 7 weeks. Follow-up was performed regularly, including nasal endoscopic examination and nasopharyngeal CT. Evolution was marked by disease control after 12 months of follow-up. The aim of this work is to show the rarity of this entity, describe clinical, radiological and histological features and finally discuss the treatment management.

唾液腺肿瘤诊治研究进展

唾液腺肿瘤是最常见的口腔颌面部肿瘤之一,根据国内7所口腔医学院口腔病理科的统计资料,在69902例口腔颌面部肿瘤中唾液腺上皮性肿瘤有23010例,占32.9%[1]。唾液腺肿瘤的诊断和治疗长期以来一直是北京大学口腔医院的临床特色项目,作者曾于2015年在本刊发表《北京大学口腔医院唾液腺肿瘤研究50年回顾》一文,对2012年前的50年唾液腺肿瘤研究工作做了系统性总结[2],本文介绍近10年本课题组唾液腺肿瘤诊治研究的新进展。

A Case of Pleomorphic Adenoma of the Parotid Gland with Multiple Local Recurrences through Facial to Cervical Regions

Pleomorphic adenoma is the most common benign parotid gland tumor. Although its local recurrence rate is known to be high, the recurrence extending to the cervical region is rare. Here we report a case of a young female (25 years old) with pleomorphic adenoma of the parotid gland which showed multiple recurrences through facial to cervical regions over a span of eight years. We also discuss how this benign tumor with a high recurrence rate has been treated in other cases, and how it should be treated.

The expression of Twist in salivary adenoid cystic carcinoma and its clinicopathological significance

Objective:The purpose of this study was to investigate the expression of Twist in salivary adenoid cystic carcinoma (SACC) and the relations between Twist expression and the clinicopathological characteristics. Methods: The expression of Twist was examined immunohistochemically in 48 cases of SACC, 18 of pleomorphic adenoma and 10 of normal parotid gland. The relationship between Twist expression in SACC and the clinicopathological factors was analyzed. Results: Twist expression was significantly higher in SACC tissues compared with pleomorphic adenomas and normal parotid gland tissues (P<0.05). Twist expression levels in SACC were significantly associated with histological type, perineural invasion, postoperative recurrence, and distant metastasis (P<0.05), rather than age, gender, tumor site, tumor size, or clinical staging (P>0.05). Conclusion: Twist expression may be associated with tumor cell differentiation, perineural invasion and metastasis of SACC. Twist expression is a potential prognostic factor for disease survival of SACC.

口腔癌调强放疗中靶区优化对患者口腔黏膜反应、唾液腺功能的影响

目的:分析口腔癌调强放疗中靶区优化对患者口腔黏膜反应、唾液腺功能的影响。方法:选择2020年4月至2022年8月江苏大学附属医院收治的120例口腔癌患者,按随机数表法分组。对照组60例,接受常规调强放疗。试验组60例,在调强放疗中对颈部Ⅱ区与口腔靶区进行优化。对比两组调强放疗后3个月疗效、腮腺受量、急性口腔黏膜反应发生率、口干反应发生率与口腔疼痛发生率,并观察放疗前、放疗第4周、放疗结束、放疗后3个月患者腮腺、颌下腺静息状态下表观弥散系数(ADC)值变化。结果:试验组客观缓解率与对照组相比[80.00%(48/60)vs 75.00%(45/60)],差异无统计学意义(P>0.05);试验组健侧腮腺限制平均照射剂量(D_(mean))、V_(34)及口腔D_(mean)、V_(30)均比对照组低(P<0.05);试验组放疗后3个月急性口腔黏膜反应、口干反应与口腔疼痛发生率(41.67%、50.00%、58.33%)均比对照组(75.00%、78.33%、85.00%)低(P<0.05);两组放疗第4周、放疗结束、放疗后3个月腮腺、颌下腺静息状态下ADC值均比放疗前升高(P<0.05);试验组放疗第4周、放疗结束、放疗后3个月腮腺、颌下腺静息状态下ADC值均比对照组低(P<0.05)。结论:口腔癌调强放疗中靶区优化可有效预防相关口腔黏膜炎的发生,降低口腔黏膜反应、口腔疼痛及口干程度,减少腮腺受量,减轻调强放疗对患者唾液腺功能的影响。

Myoepithelial carcinoma of the salivary glands: behavior and management

To investigate the biological behavior and proper management of myoepithelial carcinomas of salivary glands Methods Twenty seven cases of myoepithelial carcinoma of salivary glands were retrospectively studied and their detailed clinical and follow up data were presented Results The subjects consisted of 17 men and 10 women aged 16 to 73 years (mean age: 51 years) The parotid gland was the most common site (n=14) of cancer Clinical features included extensive local growth, invasion of the surrounding tissues, infrequent cervical lymph node metastasis but high rates of distant metastasis, frequent/multiple recurrences and poor prognosis Conclusions Myoepithelial carcinomas of the salivary gland should be classified as high grade malignancies Early and radical surgery with close follow up are essential for achieving favorable outcomes Radiotherapy appears to be non sensitive and elective neck dissection is generally unnecessary

涎腺肿瘤3461例临床病例分析

目的 :了解涎腺肿瘤发病情况、构成特点及发展趋势。方法 :对四川大学华西口腔医院 195 5～ 2 0 0 2年间收治的 3 461例涎腺肿瘤临床资料进行回顾性分析。结果 :良恶性的平均发病年龄分别是 41.3 8岁和 45 .2 0岁 ,良恶性的男女之比分别是 0 .99∶1和 1.3 4∶1。腮腺、腭部的小涎腺和颌下腺分别列为涎腺肿瘤原发部位前3位 ;多形性腺瘤、腺淋巴瘤、基底细胞腺瘤与粘液表皮样癌、腺样囊性癌、腺癌分别列为良、恶性肿瘤前三位。结论 :涎腺肿瘤发病有增加的趋势 ;男性患者的构成比恶性肿瘤高于良性 ;女性患者构成比有增加趋势 ;腮腺和腭部分别是大、小涎腺肿瘤的高发部位 ;多形性腺瘤和粘液表皮样癌是最常见的涎腺良、恶性肿瘤。

涎腺肿瘤的基础与临床研究

Salivary gland tumors are a group of the most common tumors in the oral and maxillofacial region. They have features with complicated histopathologic classification and wide distribution. There is little knowledge on the clinicopathologic characterics and clinical behaviors of salivary gland tumors of various locations and subtype. The management of salivary gland tumors is also contraversial. Biopsy is not suggested because of seeding of tumor cells. Therefore adjunctive methods are important for preoperative diagnosis. Since 1985, our research group has performed a series of basic and clinical researches on salivary gland tumors including clinicopathologic characteristis and behavior, preoperative adjunctive diagnosis, mechanism, prevention and treatment of distant metastasis of salivary adenoid cystic carcinoma, and histogenesis of salivary gland tumor. These studies have improved our knowledge on the clinical, histopathological, cytological, imaging features, and biobehavior of different types of slivary gland tumors. We have also suggested related principles of management, modified the operative methods of benign tumor of parotid gland. Our efforts have raised the standards of diagnosis and treatment of salivary gland tumors.

64例大涎腺腺样囊性癌的预后因素分析

背景与目的:涎腺腺样囊性癌是一类恶性程度高的涎腺肿瘤,针对大涎腺来源的腺样囊性癌的研究较少。本研究旨在探讨影响大涎腺腺样囊性癌患者预后的因素。方法:回顾性分析1971年1月至1998年7月中山大学肿瘤防治中心收治并随诊7年以上的64例大涎腺腺样囊性癌患者的临床资料,应用Kaplan-Meier法进行生存分析,组间比较用log-rank检验,多因素分析采用Cox模型进行分析,两组比率的比较采用χ2检验。结果:本组总死亡率为57.8%,肿瘤相关死亡率为46.9%;5年、10年累积生存率分别为65.6%和54.5%;复发率为34.4%,远处转移率为45.0%;单因素分析结果显示,年龄、神经是否受侵、病理类型、临床分期、手术切缘是否干净是影响患者预后的因素。年龄≥50岁、神经受侵、病理类型为实体型或小管型、临床分期为晚期(Ⅲ、Ⅳ期)、切缘阳性者的预后较年龄<50岁、神经未受侵、病理类型为筛孔状、临床分期为早期(Ⅰ、Ⅱ期)、切缘阴性者差;多因素分析结果显示,神经受侵、病理类型为实体型、临床分期属于晚期(Ⅲ、Ⅳ期)、切缘阳性者,预后差。结论:神经是否受侵、病理类型、临床分期、手术切缘是否干净是影响大涎腺腺样囊性癌患者预后的独立因素。

颌下腺移位术预防鼻咽癌放疗后口干燥症的近期效果

背景与目的:口干燥症是鼻咽癌放疗后最常见的后遗症之一,它严重影响患者放疗后的生存质量。本研究旨在探讨颌下腺移位术预防鼻咽癌放疗后口干燥症的临床效果。方法:共选择70例病例进行前瞻性非随机临床对照研究。试验组选择符合入选标准的鼻咽癌患者36例,在放疗前将颌下腺移位至颏下区,术后接受常规放疗,放疗时颏下区设置挡块。观察放疗中急性口腔粘膜反应,应用锝-99核素扫描检测放疗前后颌下腺功能的变化,测定放疗前后唾液分泌量的变化,放疗后3个月进行口干程度问卷调查。对照组(34例)不行颌下腺移位术,其余处理方法同试验组。将试验组的术侧与非术侧以及试验组与对照组的上述观察指标进行比较。结果:试验组急性口腔粘膜反应明显轻于对照组(P=0.007)。试验组放疗后3个月移位术侧颌下腺摄取、排泌功能均明显较未移位术侧者好,两者之间有非常显著性差异(P值分别为0.001和0.000);试验组颌下腺摄取、排泌功能均明显较对照组者好,两者之间有非常显著性差异(P值分别为0.004和0.000)。试验组放疗后唾液分泌量的平均值为1.41g,而对照组放疗后唾液分泌量平均值为0.71g。对照组76.5%的患者有中度至重度的口干燥症,试验组仅13.9%的患者有中度至重度的口干燥症,两者之间有非常显著性差异(P=0.000)。

分化型甲状腺癌患者^(131)I治疗前后唾液腺功能的变化

目的观察分化型甲状腺癌(DTC)患者接受131I治疗后唾液腺功能的变化。方法对22例确诊为DTC的患者,在应用131I治疗前及治疗后3个月进行放射性核素唾液腺动态显像,并从定性、定量两方面进行唾液腺功能分析。另选取15名正常人作为对照组。结果 22例DTC患者接受131I治疗后,15例(68.18%)出现唾液腺自主排泌功能降低;治疗后双侧腮腺、颌下腺的15 min摄取分数(UR15)明显降低,双侧腮腺排泌分数(SR)降低,但颌下腺的SR值变化不明显。与对照组相比较,治疗后双侧腮腺、颌下腺的UR15值和SR值均降低。结论 DTC患者在接受131I治疗后大多数患者自主唾液腺排泌功能下降;双侧腮腺和颌下腺摄取和排泌功能均降低。

涎腺肌上皮癌12例临床病理分析

目的探讨涎腺肌上皮癌(myoepithelial carcinoma,MEC)的临床病理学及免疫表型特征,以期提高该病的诊断和治疗水平。方法采用HE及免疫组化法对12例涎腺MEC进行检测,对其组织形态学及免疫表型进行分析,并复习相关文献。结果MEC组织以透明、淡染细胞多见,部分病例可见浆细胞样细胞、上皮细胞及梭形细胞,癌细胞呈巢团状、实性片状或梁索状排列;核分裂象易见;细胞异型性明显;4例中可见坏死。免疫表型:12例表达CK,8例表达EMA,11例表达p63和CK5/6,10例表达S-100,4例表达vimentin,2例表达Calponin,1例表达SMA,Ki-67增殖指数5%~40%。结论 MEC细胞形态多样,病理检查结合免疫表型可提高该病的确诊率,治疗以手术切除为主。

柠檬酸对分化型甲状腺癌患者首次131I治疗后唾液腺功能的保护作用

目的:探讨柠檬酸对术后首次行 131I治疗(简称清甲治疗)的分化型甲状腺癌(DTC)患者唾液腺功能的影响,阐明柠檬酸对 131I治疗的甲状腺癌患者唾液腺功能的保护作用。方法:经患者知情同意,随机选择准备首次行 131I治疗的68例甲状腺乳头状癌患者,随机分为对照组和柠檬酸组,每组34例。对照组患者无特殊准备,柠檬酸组患者于 131I治疗前1周及治疗后3周内每天含柠檬酸1 min(0.2 g/次)后吐出。2组患者分别于 131I 治疗前24 h及 131I治疗后3个月行2次 99m TcO 4 -唾液腺显像检查,计算第15分钟摄取指数(15 min UI)和排泌分数(SR),评估唾液腺功能。结果:与 131I治疗前比较,对照组患者 131I治疗后右侧腮腺和双侧颌下腺 15 min UI差异无统计学意义(P>0.05),左侧腮腺15 min UI降低(P<0.05);与 131I治疗前比较,柠檬酸组患者 131I治疗后双侧腮腺及双侧颌下腺15 min UI差异无统计学意义(P>0.05);与对照组比较,柠檬酸组患者 131I治疗前后双侧腮腺和双侧颌下腺15 min UI差异均无统计学意义(P>0.05)。与 131I治疗前比较,对照组患者双侧腮腺治疗后SR降低(P<0.05),双侧颌下腺SR差异无统计学意义(P>0.05),柠檬酸组患者双侧腮腺和双侧颌下腺治疗后SR差异无统计学意义(P>0.05);与对照组 131I治疗后比较,柠檬酸组患者双侧腮腺SR升高(P<0.05),双侧颌下腺SR差异无统计学意义(P>0.05)。结论: DTC患者术后首次 131I治疗后唾液腺排泌功能可能受损,短期口含柠檬酸对唾液腺具有保护作用,可以减轻唾液腺的放射性损伤。