Zhang Ping, Tang Li-Juan, Gao Huan-Huan, Zhang Wen-Xin, Lin Jian-Xian, Yang Hua-Sheng
Department of Ocular Pathology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Department of Orbital Disease and Oncology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Int J Ophthalmol. 2019 Aug 18;12(8):1238-1242. doi: 10.18240/ijo.2019.08.02. eCollection 2019.
To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma (Ca-ex-PA) and pleomorphic adenoma (PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them.
We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed.
Median age of PA was 43.2y (from 21 to 75). The 35 patients (54.7%) were male and 29 patients (45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%; the average proliferation index of Ki-67 was 3.2%; pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3y (from 26 to 76). There were 7 male patients (46.7%) and 8 female patients (53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%; the average proliferation index of Ki-67 was 29.2%; pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas.
PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-ex-PA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-ex-PA and PA.
研究泪腺多形性腺瘤恶变（Ca-ex-PA）和多形性腺瘤（PA）的C-myc、Ki-67、广谱细胞角蛋白和波形蛋白免疫组化特征，以便为两者的鉴别诊断寻找线索。
回顾性分析64例泪腺PA和15例泪腺Ca-ex-PA的显微切片和临床记录。采用C-myc、Ki-67、广谱细胞角蛋白和波形蛋白免疫组化抗体。
PA患者的中位年龄为43.2岁（21至75岁）。男性35例（54.7%），女性29例（45.3%）。PA中，C-myc平均阳性率为4.6%；Ki-67平均增殖指数为3.2%；广谱细胞角蛋白在导管细胞中呈阳性，波形蛋白在肌上皮细胞中呈阳性。Ca-ex-PA患者的中位年龄为54.3岁（26至76岁）。男性7例（46.7%），女性8例（53.3%）。15例Ca-ex-PA中，有6例肌上皮癌、4例腺癌、3例上皮-肌上皮癌和2例鳞状细胞癌。Ca-ex-PA中，C-myc平均阳性率为36.4%；Ki-67平均增殖指数为29.2%；广谱细胞角蛋白在所有病例中均呈阳性，波形蛋白在肌上皮癌中呈阳性。
PA的C-myc和Ki-阳性率较低，而Ca-ex-PA的这两种生物标志物阳性率较高。这四种生物标志物作为一组可为Ca-ex-PA和PA的鉴别诊断提供有价值的线索。我们的结果表明，C-myc的激活可能在Ca-ex-PA和PA的发病机制中起重要作用。
