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Title: [Clinicopathological analysis of 40 cases of salivary duct carcinoma].
Author: Lin N, Cai JH, Xu MJ, Kang P, Cheng ZF, He W.
Journal: Zhonghua Kou Qiang Yi Xue Za Zhi; 2019 Jun 09; 54(6):416-419. PubMed ID: 31177683.
Abstract:
Objective: To investigate the clinical manifestations and pathological changes of salivary duct carcinoma (SDC) and the relationship between them, so as to provide reference for the diagnosis of SDC. Methods: In this retrospective analysis 40 cases of SDC diagnosed from January 2012 to August 2018 in the Department of Pathology of the First Affiliated Hospital of Zhengzhou University were enrolled and the clinical and pathological characteristics were analyzed, 29 were male and 11 were female, the ratio of male to female was 2.64∶1, the median age was 59.0 years, the average course of disease was 3.5 years. The reported cases of SDC were reviewed and compared with patients of this study. Results: Among the 40 patients, 24 cases occurred in parotid gland, 9 cases in submandibular gland and 7 cases in small salivary glands; 24 cases had cancer cell infiltration and invasion of adjacent tissues, 11 cases had lymph node metastasis and 9 cases had distant metastasis at the time of diagnosis. Pathological results showed that 27 cases belonged to primary salivary duct carcinoma, 13 cases belonged to malignant transformation of pleomorphic adenoma; 10 cases invaded local nerve, 22 cases invaded glandular lobules and ducts. Immunohistochemical results showed that 33 cases were positive for androgen receptor, 27 cases were positive for cytokeratin-7, 22 cases were positive for human epidermal growth factor receptor-2, 8 cases were positive for gross cyst disease fluid protein 15. The proliferation index of nuclear antigen Ki-67 ranged from 10% to 90%. Among them 18 cases were over 50% and 22 cases were below 50%. Conclusions: Salivary duct carcinoma is a rare and highly malignant tumor of the salivary gland. Accurate pathological diagnosis is helpful to inhibit the early local recurrence, distant metastasis and improve survival rate of salivary duct carcinoma. 目的： 探讨唾液腺导管癌（salivary duct carcinoma，SDC）的临床表现、病理变化及两者的关系，为SDC的诊断提供参考。 方法： 回顾性分析2012年1月至2018年8月郑州大学第一附属医院病理科终诊断为SDC的患者40例，男性29例，女性11例，男女比例2.64∶1，患者年龄（59.1±11.0）岁（38~80岁，中位年龄59.0岁），病程1个月至15年，平均病程3.5年。分析其临床及病理学特征，同时回顾国内外文献报道的SDC病例，与本组40例SDC病例进行比较。 结果： 40例患者中24例发生于腮腺，9例发生于下颌下腺，7例发生于小唾液腺；诊断时已伴癌细胞浸润及侵犯邻近组织者共24例，淋巴结转移11例，远处转移9例。病理结果显示40例中27例属于原发性唾液腺导管癌，13例属于多形性腺瘤恶变；10例局部侵犯神经，22例侵犯腺体小叶及导管。免疫组织化学结果显示，33例雄激素受体阳性，27例抗细胞角蛋白7阳性，22例原癌基因人类表皮生长因子受体2阳性，8例大囊肿病液体蛋白15阳性，核抗原Ki-67增殖指数为10%~90%，其中≥50%者18例，<50%者22例。 结论： SDC恶性程度极高，周围组织浸润侵袭性强，易复发及远处转移，预后较差。根据SDC的临床表现、病理变化，辅以免疫组化检查，可为早期诊断、判断局部复发及转移提供参考。.

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