Jastrzebski André, Brownstein Seymour, Jordan David R, Gilberg Steven M
Department of Ophthalmology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada ; Department of Pathology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada.
Saudi J Ophthalmol. 2012 Apr;26(2):205-10. doi: 10.1016/j.sjopt.2012.01.004. Epub 2012 Jan 20.
To elucidate the distinct histochemical and immunohistochemical profile of mucoepidermoid carcinoma of the conjunctiva (MECC) and to determine which combination of stains is most useful in diagnosing MECC and differentiating it from squamous cell carcinoma of the conjunctiva (SCC) in cases where the clinical or cytological findings are not definitive.
Eight specimen of MECC from 4 patients and 4 specimens of SCC from 4 patients were examined using a variety of special stains and immunohistochemical markers. The results were then analyzed for usefulness in diagnosing MECC.
The most useful markers in diagnosing MECC and differentiating it from SCC are mucicarmine, colloidal iron, and alcian blue all with sensitivities of 88%, and a specificity of 100%; CEA with a sensitivity of 83% and a specificity of 75%; and, mucin-1 with a sensitivity of 100% and a specificity of 25%, but which showed a distinct pattern of staining of MECC when compared to SCC. In our series, the sensitivity of the CK7+/CK20- combination for MECC was only 38%.
The most useful stains in ruling out SCC in a suspected case of MECC were shown to be mucicarmine and the glycosaminoglycan (GAG) stains. However, in cases where mucicarmine and the GAG stains are negative or difficult to interpret and there is suspicion of a diagnosis of MECC, CEA and mucin-1 may be helpful for this diagnosis. The findings of CK7+/CK20- also may be of assistance, but are not as sensitive when compared to analogous salivary gland lesions, when differentiating MECC from SCC.
阐明结膜黏液表皮样癌（MECC）独特的组织化学和免疫组织化学特征，并确定在临床或细胞学检查结果不明确的情况下，哪种染色组合对诊断MECC以及将其与结膜鳞状细胞癌（SCC）进行鉴别最有用。
使用多种特殊染色和免疫组织化学标志物对4例患者的8份MECC标本和4例患者的4份SCC标本进行检查。然后分析结果对诊断MECC的有用性。
诊断MECC并将其与SCC区分开来最有用的标志物是黏液卡红、胶态铁和阿尔辛蓝，敏感性均为88%，特异性为100%；癌胚抗原（CEA）敏感性为83%，特异性为75%；黏蛋白-1敏感性为100%，特异性为25%，但与SCC相比，其在MECC中的染色模式明显不同。在我们的研究系列中，CK7+/CK20-组合对MECC的敏感性仅为38%。
在疑似MECC病例中，排除SCC最有用的染色方法是黏液卡红和糖胺聚糖（GAG）染色。然而，在黏液卡红和GAG染色阴性或难以解释且怀疑诊断为MECC的情况下，CEA和黏蛋白-1可能有助于诊断。CK7+/CK20-的结果也可能有帮助，但在将MECC与SCC区分时，与类似的涎腺病变相比，其敏感性不高。
