涎腺透明细胞变异型黏液表皮样癌的临床病理研究  

Clear Cell Variant of Mucoepidermoid Carcinoma of Salivary Glands:a Clinicopathological Study.

作　　者：杨邵东[1] 陈新明[2] 王丽[2] 张佳莉[2] 

机构地区：[1]海南医学院口腔系,海南海口570102 [2]武汉大学口腔医学院病理科,湖北武汉430079

出　　处：《口腔医学研究》2008年第6期676-679,共4页Journal of Oral Science Research

摘　　要：目的:报告10例涎腺透明细胞变异型黏液表皮样癌的临床病理及角蛋白表达特点。方法:回顾复习武汉大学口腔医学院1985～2006年收治、并经病理诊断为黏液表皮样癌的病例,确诊10例透明细胞变异型。全部病例行HE、PAS、AB-PAS、阿辛蓝和角蛋白免疫组织化学染色并随访。结果:本组病例约占同期所有涎腺MEC的4.7%(10/211),其中男女各5例,平均年龄42岁,腭部8例,舌根和腮腺各一例。镜下肿瘤主要由透明细胞组成的团块状或片状癌巢,其内混合少量非透明细胞(表皮样细胞或中间细胞),通常位于透明细胞的周边,呈逐渐的过渡。角蛋白免疫组化结果显示,CK7、CK8/18和CK19在所有病例中都呈强阳性表达,CK5/6、CK14、CK17和CK10/13大部分病例中呈局灶性或散在细胞表达。结论:透明细胞变异型黏液表皮样癌是黏液表皮样癌一种少见的变异,腭部多见。组织化学染色和CK10/13在透明细胞变异型黏液表皮样癌与非特异性透明细胞癌的鉴别诊断中有帮助。Objective： To report the clinicopathological and immunohistochemical characteristics of 10 cases of clear cell variant of mucoepidermoid carcinoma （CCMEC）. Methods ： All eases of salivary mucoepidermoid carcinoma （MEC） enrolled from 1985 to 2006 were reviewed, and ten cases of CCMEC were identified. Staining for hematoxylin - eosin （HE）, periodic acid - Schiff （PAS, with or without diastase digestion）, alcian blue （pH 2.5）, and cytokeratin （CK） subtypes was performed. Results： Ten cases of CCMEC represented 4.7% of all salivary gland MEC in our series. There were five males and five females, age ranged from 20 to 62 years （ mean 42）. Eight cases arose in the palate, one tumor arose in the base of tongue and one in the parotid. Histologically, CCMEC was chiefly composed of solid sheets, nests, or cords of clear cells. Clusters of non - clear cells, which was regarded as intermediate cells or epidermoid cells, appeared to merge with the clear cells. Immunohistochemically, CKs 7, 8/18, and 19 were strongly expressed in all cases. Immunoreactivity for CKs 5/6, 14, 17, and 10/13 was restricted to focal cells in most cases. Conclusion： CCMEC is rare and has a predominance for the minor glands, especially the palate. Histochemical survey of mucous ceils and assessment of the immunoexpression of CK10/13 are helpful to distinguish CCMEC from clear cell carcinoma, not other specified.

关 键 词：黏液表皮样癌 透明细胞 角蛋白 临床病理 

分 类 号：R739.8[医药卫生—肿瘤]