口腔医学研究

口腔医学研究 ›› 2025, Vol. 41 ›› Issue (8): 690-694.DOI: 10.13701/j.cnki.kqyxyj.2025.08.009

• 口腔颌面外科学研究 • 上一篇    下一篇

涎腺分泌性癌14例临床回顾性研究

王希乾1, 李聚强2#, 彭利伟1*   

  1. 1.河南省人民医院口腔颌面外科 河南 郑州 450003;
    2.河南大学口腔医学院 河南 开封 450046
  • 收稿日期:2025-02-25 出版日期:2025-08-28 发布日期:2025-08-15
  • 通讯作者: *彭利伟,E-mail:pengliw2003@aliyun.com
  • 作者简介:王希乾(1987~ ),男,河南新乡人,硕士,副主任医师,研究方向:口腔颌面肿瘤及创伤。李聚强(1997~ ),男,银川人,硕士在读,住院医师,研究方向:腮腺肿瘤。#为共同第一作者
  • 基金资助:
    2021年度河南省医学科技攻关计划省部共建青年项目(编号:SBGJ202103013)

Clinical Retrospective Study on 14 Cases of Secretory Carcinoma of Salivary Gland

WANG Xiqian1, LI Juqiang2#, PENG Liwei1*   

  1. 1. Department of Oral and Maxillofacial Surgery, Henan Provincial People’s Hospital, Zhengzhou 450003, China;
    2. School of Stomatology, Henan University, Kaifeng 450046, China
  • Received:2025-02-25 Online:2025-08-28 Published:2025-08-15

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摘要： 目的: 分析涎腺分泌性癌(secretory carcinoma of salivary gland,SCSG)的临床表现、影像特点、病理特征及鉴别诊断、治疗方法及预后情况,为该病的诊疗提供依据。方法: 回顾分析2018年2月~2024年8月河南省人民医院口腔颌面外科收治的14例最终病理确诊为SCSG患者的临床资料,进行全面的分析讨论。结果: 14例SCSG患者,男性12例,女性2例;发病年龄15~64岁,病程2月~26年。腮腺10例(71.4%),颌下腺1例,小唾液腺3例。肿瘤直径1.5~7.8 cm。本组14患者均行手术切除,免疫组化指标细胞角蛋白7(cytokeratin 7,CK7)、S-100蛋白(S-100 protein,S-100)、GATA结合蛋白3(GATA binding protein 3,GATA3)阳性,Ki67阳性比例为5%~30%,胃肠道间质瘤发现蛋白1(discovered on GIST-1,DOG-1)阴性;其中6例进行分子病理检测均存在ETS变异体6(荧光原位杂交法)[ETS variant 6 (fluorescence in situ hybridization),ETV6(FISH)]断裂,2例伴有淋巴结转移(14.3%),1例接受了术后放、化疗,1例单纯补充放疗,3例术后局部碘离子植入;随访至2024年12月,1例术后复发。结论: SCSG是一种较为罕见的低度恶性涎腺肿瘤,预后良好;临床表现及影像学无明确特异性,确诊需依靠特征的组织形态、免疫组化及分子检测。无明确颈淋巴结转移证据时可不做预防性颈淋巴清扫。针对ETV6基因的靶向治疗可能是新的研究方向。

关键词: 涎腺分泌性癌, 乳腺样分泌性癌, 免疫组织化学, ETV6

Abstract: Objective: To discuss the clinical manifestations, imaging features, pathological features, differential diagnoses, treatment methods, and prognosis of secretory carcinoma of salivary gland (SCSG). Methods: A total of 14 SCSG patients admitted to the Department of Oral and Maxillofacial Surgery, Henan Provincial People’s Hospital from February 2018 to August 2024 were enrolled. Clinical data were retrospectively analyzed, and a comprehensive analysis and discussion were carried out. Results: Fourteen patients were included (12 males and 2 females), aged 15-64 years (mean age 48.4 years). The disease duration ranged from 2 months to 26 years. Tumor locations included the parotid gland (10 cases), submandibular gland (1 case), hard palate (1 case), and lip (2 cases). Tumor diameters ranged from 1.5 to 7.8 cm. All patients underwent surgical resection. Immunohistochemical analysis revealed strong diffuse positivity for Cytokeratin 7 (CK7), S-100 protein (S-100), and GATA binding protein 3 (GATA3) in all cases. The Ki67 proliferation index ranged from 5% to 30%, and Ets variant 6 (ETV6) rearrangements were detected in 6 cases. Lymph node metastasis was observed in 2 cases (14.3%). Postoperative interventions included radiotherapy/chemotherapy (1 case), radiotherapy alone (1 case), and radioactive particle implantation (3 cases). During follow-up until December 2024, recurrence was observed in 1 case. Conclusion: SCSG is a rare low-grade malignant salivary gland tumor with a favorable prognosis. The clinical manifestations and imaging features are not specific. Diagnosis mainly depends on characteristic histopathology, immunohistochemistry, and molecular detection. Prophylactic cervical lymph node dissection is unnecessary in the absence of confirmed metastasis. Targeted therapy against ETV6 rearrangements may represent a novel therapeutic avenue.

Key words: secretory carcinoma of salivary gland, mammary analogue secretary carcinoma of salivary gland, immunohistochemistry, ETV6