He Jie-Hua, Zong Yong-Sheng, Luo Rong-Zhen, Liang Xiao-Man, Wu Qiu-Liang, Liang Ying-Jie
Department of Pathology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China.
Ai Zheng. 2003 Jul;22(7):753-7.
BACKGROUND & OBJECTIVE: The primary nasopharyngeal adenocarcinoma (NPAC) is rare. This study was designed to investigate the clinicopathological characteristics of primary NPAC.
A series of carcinoma biopsies taken from the nasopharynx of the patients followed at Cancer Center, Sun Yat-sen University were reviewed during 24 years. The clinical data and paraffin blocks of 39 NPAC patients were used for this study. In addition, the clinical manifestations of 177 nasopharyngeal carcinoma (NPC) patients were adopted as control. HE, Alcian blue, and PAS histochemical staining were performed and then the morphology was observed under microscope.
(1) There were 153 NPACs found in 31791 carcinomas of the nasopharynx; thus the hospital-based frequency of NPAC was 0.48% (153/31791). (2) The median age of 39 NPAC patients was 46.0 years old and the age peak was 40-49 age group. (3) Seventeen out of 39 NPAC patients (43.5%) were female. (4) Most of NPAC tumors (23/38) took growth beyond the nasopharyngeal cavity (T3) and/or invasion to the cranial bone and/or cranial nerves (T4). Furthermore, only 7 NPAC patients (7/39, 17.95%) had lymph node metastasis; and on the contrary, there were 136 out of the 177 patients (136/177, 76.84%) with NPC had lymph node(s) metastasis. There was significant difference between these two percentages (17.95% vs. 76.84%, P< 0.01). (5) The 39 NPACs could be classified into 2 categories, namely conventional type (16 cases) and salivary gland type (23 cases). The conventional type could further be graded as low-grade (9 cases) and high-grade (7 cases). The 23 salivary-gland type NPACs consisted of 17 adenoid cystic carcinomas and 6 mucoepidermoid carcinomas. (6)The continuation of neoplastic cells to surface lining epithelium was presented in 7 conventional type adenocarcinomas (including all 5 papillary adenocarcinomas) and 4 mucoepidermoid carcinomas. The transition from the adenoid cystic carcinoma cells to the atypical hyperplastic lesion of the ductal epithelium of minor salivary gland was observed in 2 cases.
The primary NPAC is uncommon. The age distribution of NPACs is not different from that of NPCs. Most patients show significant local invasion, but scarce cervical lymph node metastasis, especially adenoid cystic carcinomas.
原发性鼻咽腺癌（NPAC）较为罕见。本研究旨在探讨原发性NPAC的临床病理特征。
回顾中山大学肿瘤防治中心24年间收治的一系列鼻咽癌患者的鼻咽活检标本。本研究采用39例NPAC患者的临床资料及石蜡块。此外，选取177例鼻咽癌（NPC）患者的临床表现作为对照。进行苏木精-伊红（HE）、阿尔辛蓝和过碘酸雪夫（PAS）组织化学染色，然后在显微镜下观察形态。
（1）在31791例鼻咽癌中发现153例NPAC；因此，基于医院的NPAC发生率为0.48%（153/31791）。（2）39例NPAC患者的中位年龄为46.0岁，年龄高峰在40-49岁组。（3）39例NPAC患者中有17例（43.5%）为女性。（4）大多数NPAC肿瘤（23/38）生长超出鼻咽腔（T3）和/或侵犯颅骨和/或颅神经（T4）。此外，只有7例NPAC患者（7/39，17.95%）有淋巴结转移；相反，177例NPC患者中有136例（136/177，76.84%）有淋巴结转移。这两个百分比之间存在显著差异（17.95%对76.84%，P<0.01）。（5）39例NPAC可分为2类，即传统型（16例）和涎腺型（23例）。传统型可进一步分为低级别（9例）和高级别（7例）。23例涎腺型NPAC包括17例腺样囊性癌和6例黏液表皮样癌。（6）7例传统型腺癌（包括所有5例乳头状腺癌）和4例黏液表皮样癌中可见肿瘤细胞延续至表面被覆上皮。2例观察到腺样囊性癌细胞向小涎腺导管上皮非典型增生病变的转变。
原发性NPAC不常见。NPAC的年龄分布与NPC无异。大多数患者表现为明显的局部侵犯，但颈部淋巴结转移少见，尤其是腺样囊性癌。
