Cope W, Naugler C, Taylor S M, Trites J, Hart R D, Bullock M J
Cellular Pathology, Royal Victoria Infirmary, Newcastle-upon-Tyne, NE1 4LP, UK.
Head Neck Pathol. 2014 Mar;8(1):73-6. doi: 10.1007/s12105-013-0477-5. Epub 2013 Jul 19.
A predominant theory of the much debated histogenesis of Warthin tumor (WT) is that it arises from heterotopic salivary ductal inclusions (SDI) in parotid lymph nodes (LN). If this were the case, we might expect to see an increased number of SDI in the lymph nodes of patients with WT compared to controls. To test this, we compared the prevalence of SDI in patients with WT versus those with pleomorphic adenoma (PA). Cases of WT and PA were retrieved from the case files of the Department of Pathology at the QEII Health Science Centre, Halifax, NS, Canada. We then compared the prevalence of SDI in parotid LN between patients diagnosed with WT versus PA. 46 WT and 52 PA met our inclusion criteria. WT was significantly associated with an older age at surgery (62.5 years vs 50.2 years, p = 0.001). 71.7 % of WT and 32.7 % of PA had inclusions in any LN. The presence of inclusion is a significant predictor for WT versus PA (p = 0.019). Where smoking status was available, 92.5 % of WT patients were smokers/ex-smokers, versus. 55.1 % of PA (p = 0.034 for current smokers). Among PA, 44 % of smokers had inclusions compared with 22.7 % of non-smokers. SDIs are more frequent in parotid LN from patients with WT than PA. The high proportion of smokers among WT patients is consistent with prior studies. The results support the hypothesis that WT arises from SDIs. Individuals with more SDIs may be predisposed to WT.
关于沃辛瘤（WT）备受争议的组织发生学，一个主流理论认为它起源于腮腺淋巴结（LN）中的异位涎腺导管包涵体（SDI）。如果真是这样，我们可能会预期，与对照组相比，WT患者淋巴结中的SDI数量会增加。为了验证这一点，我们比较了WT患者与多形性腺瘤（PA）患者中SDI的发生率。WT和PA的病例取自加拿大新斯科舍省哈利法克斯市QEII健康科学中心病理科的病例档案。然后，我们比较了被诊断为WT和PA的患者腮腺LN中SDI的发生率。46例WT和52例PA符合我们的纳入标准。WT与手术时年龄较大显著相关（62.5岁对50.2岁，p = 0.001）。71.7%的WT和32.7%的PA在任何LN中都有包涵体。存在包涵体是WT与PA的一个显著预测指标（p = 0.019）。在有吸烟状况数据的情况下，92.5%的WT患者是吸烟者/曾经吸烟者，而PA患者为55.1%（当前吸烟者p = 0.034）。在PA患者中，44%的吸烟者有包涵体，而非吸烟者为22.7%。WT患者腮腺LN中的SDI比PA患者更常见。WT患者中吸烟者的高比例与先前的研究一致。结果支持WT起源于SDI的假说。SDI较多的个体可能易患WT。
