涎腺嗜酸细胞腺瘤和嗜酸细胞腺癌的临床病理分析  

A clinicopathologic studyon oncocytoma and oncocytic carcinoma of the salivary glands

作　　者：周传香[1] 石钿印[2] 俞光岩[2] 高岩[1] 

机构地区：[1]北京大学口腔医学院.口腔医院病理科,北京100081 [2]北京大学口腔医学院.口腔医院口腔颌面外科,北京100081

出　　处：《北京大学学报（医学版）》2011年第1期52-57,共6页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(30801300)资助~~

摘　　要：目的:探讨涎腺嗜酸细胞肿瘤的临床病理特征、鉴别诊断、治疗和预后。方法:对23例嗜酸细胞腺瘤、15例嗜酸细胞腺癌的临床特点、病理表现及组织化学、免疫组织化学和电子显微镜观察结果进行观察、分析,同时对所有病例进行随访,分析患者的治疗和预后。结果:嗜酸细胞腺瘤多发生于腮腺(95.6%),23例患者经局部切除后均无复发,诊断主要依赖组织病理学检查,即肿瘤由嗜酸细胞构成,包膜完整。嗜酸细胞腺癌亦为腮腺多发,是一种恶性程度较高的涎腺肿瘤,局部复发(50%)、区域淋巴结转移(50%)和远处转移率(28.6%)都较高,根治性手术是首选治疗方案,该肿瘤的诊断除依据常规病理特点外,组织化学、免疫组织化学和电子显微镜观察均可证明嗜酸细胞胞浆颗粒为大量线粒体,可辅助诊断,其中免疫组织化学方法因特异性强、简单易行更加适用。结论:涎腺嗜酸细胞肿瘤较少见,嗜酸细胞腺瘤预后较好,肿瘤切除后很少复发;嗜酸细胞腺癌预后差,根治性手术是首选治疗方案,肿瘤诊断主要依靠组织病理学检查,线粒体免疫组织化学有助于诊断和鉴别诊断。Objective：To investigate the clinicopathologic features,differential diagnosis,treatment and prognosis of oncocytoma and oncocytic carcinoma of the salivary glands.Methods： The clinicopathologic features were studied in 23 cases of oncocytomas and 15 cases of oncocytic carcinomas,and immunohistochemical staining as well as electron microscopy were performed.Results： Most oncocytomas occurred in the parotid gland（95.6%） with no recurrence.The diagnosis was made based on histopathological features.Oncocytic carcinomas were high-grade tumors,mainly occurring in the parotid gland.The diagnosis was based not only on histopathology but also on ultrastructural findings,phosphotungstic acid hematoxylin（PTAH）,and immunohistochemistry.Of the 14 cases with follow-up information,7 cases recurred.Regional or distant metastases were found in 7 and 4 cases,respectively.Conclusion： Oncocytoma is a rare tumor with well prognosis,whereas oncocytic carcinoma of the salivary glands is a high-grade tumor,with frequent local recurrence,regional or distant metastasis,the diagnosis of which should be based on a combination of clinical and histopathological features.Immunohistochemistry for mitochondria is considered as a practical and helpful adjuvant for diagnosis.

关 键 词：涎腺肿瘤 腺瘤 嗜酸性 腺癌 免疫组织化学 诊断 鉴别 

分 类 号：R739.87[医药卫生—肿瘤]