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目的 探讨涎腺恶性肌上皮瘤的临床病理特征及生物学行为。方法 采用组织病理学和免疫组化方法对 2 2例恶性肌上皮瘤进行分析。结果 好发于腮腺和腭腺 ;男性多见 (男女之比 2 3∶1) ;中位年龄4 9岁。病理特征为透明细胞型和上皮样细胞型多见 ,呈巢索状分布 ;细胞异型性明显 ,有病理性核分裂像 ;广泛浸润周围组织。免疫组化染色Actin、Ck 18、EGFR、TGFβ均呈明显的强阳性表达 ;PCNA阳性表达的平均增殖指数是 2 2 8%± 6 93,以透明细胞型的PI值为最高 ;癌基因C erbB 2、抑癌基因P53分别呈 63 6%和31 8%的阳性表达 ,各型的表达也以透明细胞型为最高。结论 恶性肌上皮瘤是一种上皮性肿瘤 ,其亚型透明细胞型恶性程度较高。C erbB 2、P53和PCNA的异常表达及协同作用在恶性肌上皮瘤的发生发展中起重要作用。
Objective To investigate the clinicopathological features and biological behavior of malignant salivary myoepithelial neoplasia. Methods Twenty-two malignant myoepithelial tumors were analyzed by histopathology and immunohistochemistry. The results occurred in the parotid gland and parotid gland; more common in men (men and women ratio of 2 3:1); median age of 4 years old. Pathological characteristics of clear cell type and epithelioid cell type are more common, showing a nest-like distribution; cell atypical, with pathological mitotic figures; extensive infiltration of the surrounding tissue. Immunohistochemical staining of Actin, Ck 18, EGFR, and TGFβ all showed strong positive expression. The average proliferative index of PCNA positive expression was 268±6.93. The clear cell type had the highest PI value; oncogene C erbB 2. The tumor suppressor gene P53 showed positive expression of 63 6% and 31 8%, respectively, and the expression of all types was also highest in the clear cell type. Conclusion Malignant myoepithelial neoplasia is an epithelial neoplasm with a high degree of malignancy of subtype clear cell type. Abnormal expression and synergistic effects of erbB2, P53 and PCNA play an important role in the development of malignant myoepithelioma.