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目的研究并分析耳鼻咽喉黏液表皮样癌的临床病理特征,并对耳鼻咽喉黏液表皮样癌的鉴别诊断方法进行探讨。方法收集我院2005年1月~2016年12月期间共收治的120例耳鼻咽喉黏液表皮样癌病例资料进行回顾性研究分析,对其临床病理特点、X线、CT、超声、病理细胞学及病理组织学诊断结果进行分析。结果 120例耳鼻咽喉黏液表皮样癌的性别分布以男性为主,年龄分布以中老年人群为主。病理类型以高分化型为主,共110例,占91.67%,黏液细胞构成比重较高,表皮样细胞分化良好,核异形、核分裂极为少见,往往存在淋巴细胞浸润;低分化型黏液表皮样癌共10例,占8.33%,其黏液细胞构成比较低,通常低于10%,多由表皮样细胞或中间细胞构成,存在核异形、核分裂情况,且细胞浸润性较强。CT、超声对耳鼻咽喉黏液表皮样癌的阳性检出率高于X线,但不及病理细胞学、病理组织学,病理细胞学与病理组织学的诊断结果较为接近,需与腺样囊性瘤、多形性腺瘤进行鉴别诊断。结论耳鼻咽喉黏液表皮样癌多分布于中老年男性人群,病理类型多为高分化型,其病理类型不同,病理特征也不同,临床诊断时应结合临床病史、影像学检查结果、病理学检查结果进行综合诊断,并注意与腺样囊性瘤、多形性腺瘤进行鉴别区分。
Objective To study and analyze the clinicopathological features of the mucoepidermoid carcinoma of the otolaryngopharynx and investigate the differential diagnosis of mucoepidermoid carcinoma of the otolaryngopharyngal mucosa. Methods The data of 120 cases of ENT treated in our hospital from January 2005 to December 2016 were retrospectively analyzed. The clinical and pathological features, X-ray, CT, ultrasonography, pathological cytology, Histopathological diagnosis results were analyzed. Results 120 cases of otolaryngopharyngeal mucoepidermoid carcinoma of the male gender-based distribution, the age distribution in the elderly population. A total of 110 cases (91.67%) were pathologically characterized with high proportion of mucous cells, well differentiated epidermal cells, abnormal nuclei and mitotic division, and lymphocyte infiltration was often observed. Poorly differentiated mucoepidermoid carcinoma A total of 10 cases, accounting for 8.33%, the mucus cells are relatively low, usually less than 10%, mostly composed of epidermal cells or intermediate cells, the presence of nuclear heterofibrosis, and cell infiltration is strong. CT, ultrasound detection of mucoepidermoid carcinoma of the otolaryngopharyngeal positive rate was higher than the X-ray, but less than the pathological cytology, histopathology, pathological cytology and histopathology diagnosis results are similar to adenoid cystic neoplasm , Pleomorphic adenoma for differential diagnosis. Conclusions Otolaryngology mucoepidermoid carcinoma is mainly distributed in the middle-aged and elderly male population. Most of the pathological types are well-differentiated, with different pathological types and pathological features. Clinical diagnosis should be based on clinical history, imaging findings and pathological findings To conduct a comprehensive diagnosis, and pay attention to differentiate and adenoid cystic tumor, pleomorphic adenoma.