Hungermann D, Roeser K, Buerger H, Jäkel T, Löning T, Herbst H
Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster.
Pathologe. 2005 Sep;26(5):353-8. doi: 10.1007/s00292-005-0775-0.
This tutorial focuses on salivary duct carcinoma (SDC), a rare, high grade neoplasm mainly of major salivary glands. The clinical course of these tumors is characterised by extended local disease, early distant metastasis, and poor outcome. The morphology of SDC is reminiscent of breast ductal carcinomas and may occasionally cause diagnostic problems. In spite of mimicry with ductal carcinoma in situ of the breast and an in situ component, that is evident in most tumors by immunohistology with antibodies directed against high molecular weight cytokeratins (Ck), SDC is always an invasive carcinoma. By immunohistology, most tumors show reactivity with antibodies directed against Ck 7, Ck 8/18 and Ck 19 whereas a morphologically indistinguishable subgroup expresses Ck 5/6 in tumor cells in addition to residual basal epithelia. Carcinoembryonic antigen, GCDFP-15 and androgen receptor are other helpful markers in routine diagnosis of SDC. Prostate-specific antigen is detectable in some cases. Abnormal p53 expression seems to indicate an adverse prognosis. Expression of c-erbB2, the over-expression of which is associated with a poor prognosis, may form the basis for a targeted therapeutic approach for selected cases of SDC.
本教程聚焦于涎腺导管癌（SDC），这是一种主要发生于大涎腺的罕见的高级别肿瘤。这些肿瘤的临床病程特点为局部病变广泛、早期远处转移以及预后不良。SDC的形态学类似于乳腺导管癌，偶尔可能会导致诊断难题。尽管与乳腺导管原位癌及原位成分存在相似之处，大多数肿瘤通过针对高分子量细胞角蛋白（Ck）的抗体进行免疫组织化学检测可明确显示这一点，但SDC始终是浸润性癌。通过免疫组织化学检测，大多数肿瘤对针对Ck 7、Ck 8/18和Ck 19的抗体呈阳性反应，而在形态上难以区分的一个亚组除残留的基底上皮外，肿瘤细胞中还表达Ck 5/6。癌胚抗原、GCDFP - 15和雄激素受体是SDC常规诊断中的其他有用标志物。在某些病例中可检测到前列腺特异性抗原。p53异常表达似乎提示预后不良。c - erbB2的表达，其过度表达与预后不良相关，可能为部分SDC病例的靶向治疗方法奠定基础。
