【摘要】 目的 探讨涎腺腺泡细胞癌(AciCC)的临床病理学及分子遗传学特征。方法 收集以往诊断的36例AciCC及3例涎腺分泌性癌(SCSG),根据第四版《WHO(2017)头颈肿瘤分类》重新阅片筛选(25例AciCC,14例SCSG),分析形态学特点，并行免疫组化及FISH检测。结果 25例AciCC发病年龄24～80岁，80%发生于腮腺，肿瘤最大径1.5～6.0 cm。镜下瘤细胞呈实性、微囊状、乳头状等混合性生长，浆液性腺泡细胞及闰管样细胞为主，胞质内可见嗜碱性酶原颗粒，细胞异型性小。免疫组化AciCC示NR4A3(24/25)、Dog-1(23/25)均阳性；25例均未见Pan-TRK、S-100、Mammaglobin表达。其中24例AciCC的Ki-67<5%,FISH检测AciCC(13/25)具有NR4A3基因重排。结论 涎腺AciCC是一种低度恶性肿瘤，其组织学形态与SCSG存在交叉重叠，分子遗传学方面大部分病例具有NR4A3基因重排。更多还原

【Abstract】 Objective To investigate the clinicopathological and molecular genetic features of acinic cell carcinoma(AciCC). Methods A total of 36 cases of AciCC and 3 cases of secretory carcinoma of the salivary gland(SCSG) were collected from the cases dignosed before. The 25 cases of AciCC and 14 cases of SCSG were reselected to perform morphologic analysis, immunohistochemical staining and FISH detection according to the WHO classification of head and neck tumors in 2017(4th edition). Results Among the 25 cases of AciCC, the onset age ranged from 24 to 80 years. 80% of the tumors developed in the parotid gland. The maximum diameter of neoplasm was 1.5 cm-6.0 cm. Microscopically, the tumor cells presented mixed growth of solid, microcystic and papillary patterns, then the serous acinar cells and intercalary tubuloid cells were dominant. There were probasophil granules in the cytoplasm with mild cellular atypia. Immunohistochemistry showed that NR4A3(24/25) and Dog-1(23/25) were positive in AciCC, but Pan-TRK, S-100 and mammaglobin were not expressed in all cases. Ki-67 were less than 5% in 24 cases. Meanwhile, FISH detection indicated that NR4A3 gene rearrangement existed in 13 cases of AciCC. Conclusion AciCC is a low-grade malignant tumor and overlapped with SCSG in histological morphology. Most cases show a NR4A3 gene rearrangement in molecular genetics.更多还原