Ussmüller J, Donath K, Hartwein J
Univ.-Hals-Nasen-Ohren-Klinik und Poliklinik, Universitätskrankenhaus Hamburg-Eppendorf.
Laryngorhinootologie. 1994 Sep;73(9):482-7. doi: 10.1055/s-2007-997177.
The mucoepidermoid carcinomas of the salivary glands (MEC) show histologically a wide spectrum of differentiation from solid epidermoid tumours to cystic mucous-filled tumours. Epidermoid cells, mucous cells and intermediate cells are the main cellular components. Besides clear cell (11.0%) and oncocytic (0.6%) variants and "cystic" (25.4%) tumours can be observed. According to the per cent of mucous cells and cystic spaces of the total tumour mass different degrees of histomorphologic differentiation can be distinguished. Therefore highly differentiated MEC (53.2%) with more than 50% mucous cells and cystic spaces, respectively low-differentiated MEC (46.8%) showing less than 50% mucous cells and cystic spaces can be subclassified. In respect of the therapeutic proceeding it should be recognized that the histopathological subclassification of MEC of the salivary glands (7) is based on morphological criteria only. It may not be equalized with a grading of malignancy since even highly differentiated MEC can grow infiltratively, sometimes osseo-destructively, to recur locally and to metastasize predominantly into the regional lymph nodes. Consequently the histopathological subclassification of MEC does not allow certain prognosis in individual cases.
涎腺黏液表皮样癌(MEC)在组织学上表现出从实性表皮样肿瘤到充满黏液的囊性肿瘤的广泛分化谱。表皮样细胞、黏液细胞和中间细胞是主要的细胞成分。此外,还可观察到透明细胞(11.0%)和嗜酸性细胞(0.6%)变体以及“囊性”(25.4%)肿瘤。根据黏液细胞和囊性间隙占肿瘤总体积的百分比,可区分不同程度的组织形态学分化。因此,黏液细胞和囊性间隙分别超过50%的高分化MEC(53.2%),以及黏液细胞和囊性间隙少于50%的低分化MEC(46.8%)可进一步分类。就治疗过程而言,应认识到涎腺MEC的组织病理学亚分类(7)仅基于形态学标准。它不能等同于恶性分级,因为即使是高分化的MEC也可能呈浸润性生长,有时会破坏骨质,从而局部复发并主要转移至区域淋巴结。因此,MEC的组织病理学亚分类无法对个别病例做出确切的预后判断。