口腔医学研究

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (11): 1013-1018.DOI: 10.13701/j.cnki.kqyxyj.2024.11.013

• 影响涎腺导管癌预 • 上一篇    下一篇

影响涎腺导管癌预后的临床病理因素和免疫组化标记物

宝鲁日1,2, 施琳1,2*   

  1. 1.内蒙古医科大学基础医学院病理教研室 内蒙古 呼和浩特 010010;
    2.内蒙古医科大学附属医院病理科 内蒙古 呼和浩特 010010
  • 收稿日期:2024-03-06 出版日期:2024-11-28 发布日期:2024-11-27
  • 通讯作者: *施琳,E-mail:13684757835@163.com
  • 作者简介:宝鲁日(1981~ ),女,内蒙古通辽市人,硕士,实验师,主要从事口腔颌面部肿瘤疾病研究。
  • 基金资助:
    2022年内蒙古自然科学基金(项目号:2022 LHMS08003)

Clinicopathological Factors and Biomarker Immunoprofile Affecting Prognosis of Salivary Ductal Carcinoma.

BAO Luri1,2, SHI Lin1,2*   

  1. 1. Department of Pathology, Inner Mongolia Medical University, Hohhot 010010, China;
    2. Department of Pathology,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010010,China
  • Received:2024-03-06 Online:2024-11-28 Published:2024-11-27

PDF (PC)

6

摘要： 目的: 探讨影响涎腺导管癌(salivary duct carcinoma,SDC)患者预后的临床病理因素和免疫组化标记物。方法: 回顾性分析23例SDC患者的临床资料并进行随访,采用苏木精-伊红(hematoxylin-eosin, HE)染色、免疫组织化学染色和人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2) 银染原位杂交(silver-enhanced in situ hybridization,SISH)检测,并进行生存回归分析。结果: 23例SDC患者中男性20例,女性3例;发病年龄39~86岁,平均年龄63.91岁;15例肿瘤发生于腮腺,8例发生于颌下腺;随访结果,术后4例复发,4例死亡,其余患者生存良好,中位随访时间43个月。肿瘤组织呈导管内筛状、巢状、实性、腺管状、条索状。在筛孔状及实性结构的中心可见粉刺样坏死。瘤细胞较大,胞浆嗜酸性、颗粒状,胞核大、多形性,核仁明显,染色质粗,核分裂像易见。免疫表型:CK7(23/23); 雄激素受体(androgen receptor,AR)(21/23);巨囊性病液体蛋白15(giant cystic disease liquid protein,GCDFP15)(17/23); p53(16/23);CK5/6(11/23);HER2(10/23),GATA结合蛋白3(GATA binding protein 3,GATA3)(10/23); CK14(3/23); p63(2/23)。不表达S-100,Ki-67增殖指数5%~80%。从免疫组织化学标记物和临床病理特征的关系,CK5/6阳性患者临床分期多为Ⅲ/Ⅳ期(P=0.009),而AR、HER2、GATA3、Ki-67增殖指数与患者的临床病理特征相关性无统计学意义(P＞0.05)。单因素、多因素生存分析结果显示临床分期是影响患者OS的危险因素(P=0.042)。结论: SDC侵袭性强,易复发和转移,CK5/6阳性患者预后不佳。

关键词: 导管癌, 涎腺肿瘤, 临床病理, 免疫组化标记物, 预后

Abstract: Objective: To explore the clinicopathological factors and biomarker immunoprofile affecting the prognosis of salivary ductal carcinoma. Methods: Retrospective analysis was applied on 23 cases of salivary ductal carcinoma including follow-up record and other clinical data collected. HE staining, immunohistochemical MaxVision two-step staining, and HER2 (HER2/Neu) gene amplification investigated by SISH were performed. Overall survival (OS) were analyzed with Kaplan-Meier curves and Cox regression. Results: Twenty-one were males and 2 were females, with an average age of 63.91 years old (39-86 years old). Tumors occurred in the parotid gland (15 cases) and submandibular gland (8 cases). Follow-up revealed 4 cases of mortality and 4 cases of relapse, while the remaining patients were survival without recurrence after surgery. The mean follow-up time was 42 months. The tumor tissue appears as heterogeneous patterns including intraductal cribriform, nest, solid, glandular tubular, and cord like structure. Acne-like necrosis was observed at the central area of the cribriform-like and solid structure. Tumor cells displayed large size, eosinophilic and granular cytoplasm, prominent and polymorphic nuclei, obvious nucleoli, dense chromatin, and visible mitotic figures. Immunophenotype was CK7 (23/23), AR (21/23), giant cystic disease liquid protein (GCDFP-15) (17/23), p53 (16/23), CK5/6 (11/23), HER2 (10/23), GATA3 (10/23), CK14 (3/23), and p63 (2/23). S-100 was not expressed. Ki-67 proliferation index ranged from 5% to 80%. CK5/6-positive cases were more often diagnosed at tumor stage Ⅲ/Ⅳ (P=0.009), while AR, HER2, GATA3, and Ki-67 proliferation indices were not related to the clinicopathological characteristics of patients (P>0.05). Univariate and multivariate survival analyses showed that clinical staging was a risk factor for OS in patients (P=0.042). Conclusion: Salivary ductal carcinoma is highly invasive, prone to recurrence and metastasis. CK5/6-positive is a potential biomarker of poor outcome in SDC.

Key words: ductal carcinoma, salivary gland tumor, clinicopathology, immunoprofile, prognosis