涎腺分泌性癌5例临床病理及预后分析
Secretory carcinoma of salivary gland:a clinicopathological and prognosis analysis of 5 cases
赵利敏 1白睿华 2王志永 1杨元元 1刘晓博1
作者信息
- 1. 郑州市第一人民医院病理科,河南 郑州 450004
- 2. 郑州大学附属肿瘤医院、河南省肿瘤医院病理科,河南 郑州 450008
- 折叠
摘要
目的 探讨涎腺分泌性癌(SCSG)的临床病理学特征、免疫表型、分子病理学特征、诊断及预后.方法 收集2019年12月至2023年2月郑州市第一人民医院及河南省肿瘤医院病理科诊断SCSG 5例病人的临床病理资料,采用苏木精-伊红(HE)、免疫组织化学染色及荧光原位杂交(FISH)进行病理学观察.结果 5例中男2例,女3例,年龄范围6～73岁;4例病变位于腮腺,1例位于上唇,临床多无明显诱因出现面部肿物前来就诊;镜下肿瘤腔内可见嗜酸性均质分泌物,细胞核大小相对一致,胞浆丰富,偶见核分裂象.免疫表型:5例肿瘤细胞广谱细胞角蛋白(CK)、细胞角蛋白7(CK7)、乳腺球蛋白(Mammaglobin)、神经特异性蛋白(S-100)、GATA结合蛋白-3(GATA-3)阳性,波形蛋白(Vimentin)及上皮膜蛋白(EMA)部分阳性,钙调理蛋白(Cal-ponin)、酪氨酸激酶生长因子受体(CD117)、DOG-1、P63阴性、Ki67(5%～20%+).5例中3例进行了ETV6-NTRK3基因融合检测,均为阳性.5例均进行了手术切除,其中1例进行了放疗;随访5例病人无瘤生存(分别随访10、16、34、38、46个月).结论 SCSG属于较为罕见的低度恶性涎腺肿瘤,易误诊为其他恶性肿瘤,免疫组织化学标志物及ETV6-NTRK3基因检测的联合应用对SCSG的诊断及治疗有较大价值.
Abstract
Objective To investigate the clinicopathological features,immunophenotype,molecular pathological characteristics,diag-noses and prognosis of secretory carcinoma of salivary gland(SCSG).Methods Clinicopathological data of 5 patients with SCSG diag-nosed in the Department of Pathology of The First People's Hospital of Zhengzhou and Henan Cancer Hospital from December 2019 to February 2023 were collected.Hematoxylin-eosin(HE)staining,immunohistochemical staining and fluorescence in situ hybridization(FISH)were used for pathological observation.Results Among the 5 patients,2 were male and 3 were female,with an age range of 6-73 years.Four lesions were located in the parotid gland,and one in the upper lip.Clinically,the patients mostly sought medical treat-ment because of facial masses without obvious inducement.Microscopically,homogeneous eosinophilic secretion was visible in the lu-men.The nuclei were relatively uniform in size.The cytoplasm was rich and occasionally showed nuclear division.Immunohistochemi-cally,generalized cytokeratin(CK),CK7,Mammaglobin,neuron-specific protein(S-100),and GATA binding protein-3(GATA-3)were positive,and Vimentin and epithelial membrane antigen(EMA)were partially positive in tumor cells of the 5 cases.Calponin,growth factor receptor tyrosine kinase(CD117),DOG-1,and P63 were negative.Ki67 was positive in 5%-20%of tumor cells.Among the 5 cas-es,3 cases were detected for ETV6-NTRK3 gene fusion,which were all positive.Five patients all underwent surgical resection,among which 1 patient received radiotherapy.During follow-up,all the 5 patients had no tumor survival(followed up for 10,16,34,38,and 46 months).Conclusion SCSG is a rare low-grade malignant salivary gland tumor which is easy to be misdiagnosed as other malignan-cies.The combined application of immunohistochemical marker and ETV6-NTRK3 gene detection is of great value for the diagnosis and treatment of SCSG.
关键词
涎腺肿瘤/广谱细胞角蛋白/神经特异性蛋白/GATA结合蛋白-3/钙调理蛋白/酪氨酸激酶生长因子受体/鉴别诊断/预后Key words
Salivary gland neoplasms/Cytokeratin/Neuron-specific protein/GATA binding protein-3/Calponin/Growth fac-tor receptor tyrosine kinase/Differential diagnosis/Prognosis引用本文复制引用
出版年
2025
NETL
NSTL
万方数据