标题：腮腺嗜酸细胞型黏液表皮样癌六例临床病理分析

      作者：李 冰，李 杰，石怀银
    (中国人民解放军总医院病理科，北京 100853)

      卷次： 2013年24卷19期

      【摘要】 目的 探讨腮腺嗜酸细胞型黏液表皮样癌的临床及病理学特点及其鉴别诊断。方法 对6例患者
的临床及病理学资料进行回顾性分析，选取有代表性的蜡块进行 p63、CK、CK7、Calponin、SMA、雄性激素受体
AR等免疫组织化学染色。结果 6例嗜酸细胞性黏液表皮样癌中男性 4例，女性 2例，年龄 41~65岁，平均 56
岁。肿瘤大小为2.5~5.5 cm，平均3.6 cm，边界呈侵袭性生长。显微镜下，肿瘤由一致的嗜酸性细胞组成，弥漫或
成巢排列，局部可见囊腔形成。6例肿瘤均可见散在的黏液细胞，其中1例局部可见经典的黏液表皮样癌区域，
但所占肿瘤比例小于5%。肿瘤细胞表现为轻度异型性，核分裂像平均1~2个/10HPF。6例中仅1例可见局灶坏
死。免疫组化染色显示 6例肿瘤均弥漫表达 p63、CK及CK7，而雄性激素受体AR、肌上皮标记物Calponin、
SMA、S-100、Vimentin均阴性。随访资料显示：6例中2例分别于术后27个月及53个月复发。随访时间最短12
个月，最长62个月，无死亡病例。结论 嗜酸细胞性黏液表皮样癌是涎腺发生的低度恶性肿瘤，临床预后较好。
p63弥漫表达有助于其诊断及鉴别诊断。

      【关键词】 黏液表皮样癌；p63；嗜酸细胞；腮腺

      【中图分类号】 R730.262 【文献标识码】 A 【文章编号】 1003—6350（2013）19—2933—03


Clinicopathological analysis of six cases of oncocytic mucoepidermoid carcinoma.
LI Bing, LI Jie, SHI Huai-yin.
Department of Pathology, Chinese PLA General Hospital, Beijing 100853, CHINA

【Abstract】 Objective To demonstrate the clinicopathological characteristics of oncocytic mucoepidermoid
carcinoma (OMEC). Methods The clinical data and clinicopathological features of six patients of OMEC were retro-
spectively analyzed. Representative blocks [p63, CK, CK7, Calponin, SMA, androgen receptor (AR)] were selected
for immunohistochemical staining. Results Of the six patients, four were males and two were females, aged from 41
to 65 years old (56 in average). The tumors were 2.5~5.5 cm in diameter (3.6 cm in average) and showed infiltrative
growth. Microscopically, the tumors were composed of uniform oncocytic cells, arranging in a diffuse or nest pattern.
Focal cyst formation was noted in all tumors. Mucin-producing cells were distributed randomly and classical mucoepi-
dermoid carcinoma element was present in one case, but less than 5% in proportion. The tumor cells showed slight nu-
clear atypia, with a mitotic rate of 1~2 per ten HPF. Immunohistochemically, the tumor cells were immunoreactive
with p63, CK and CK7, but negative for AR, Calponin, SMA, S-100, Vimentin. Follow-up showed recurrences of two
tumors at 27 and 53 months respectively. No patient died during the follow-up (12~62 months). Conclusion OMEC
is a low-grade tumor and has a favorable prognosis. p63 serves as a helpful marker in the diagnosis of OMEC.