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目的 通过对罕见的牙源性透明细胞癌 (ClearCellOdontogenicCarcinoma,CCOC)临床病理特征的分析 ,探讨其组织学形态与恶性生物学行为的关系及鉴别诊断。方法 对 1例CCOC进行了组织学、组织化学、免疫组化及透射电镜研究。结果 肿瘤细胞的CK、EMA阳性。透明细胞PAS染色阳性 ,消化后阴性 ,电镜证实有糖原颗粒 ,且以线粒体明显增生、肿胀为特征。结论 原发于颌骨内的透明细胞癌 ,PAS染色及CK、EMA的阳性表达有助于牙源性透明细胞癌的诊断 ,并支持CCOC为牙源性上皮性肿瘤。肿瘤细胞的线粒体增生明显、线粒体内糖原沉积的特征可能与其侵袭力强 ,复发、转移早等恶性生物学行为有关。
Objective To investigate the clinicopathological features of ClearCell Odontogenic Carcinoma (CCOC) and to explore the relationship between histological features and malignant biological behavior and differential diagnosis. Methods One case of CCOC was studied by histology, histochemistry, immunohistochemistry and transmission electron microscopy. Results The tumor cells were positive for CK and EMA. Transparent cell PAS staining positive, negative after digestion, electron microscopy confirmed glycogen particles, and the obvious proliferation of mitochondria, characterized by swelling. Conclusion The clear cell carcinoma, PAS staining, positive expression of CK and EMA in primary jaw are helpful for the diagnosis of odontogenic clear cell carcinoma and support the CCOC as odontogenic epithelial tumor. The mitochondrial hyperplasia of tumor cells is obvious, mitochondrial glycogen deposition may be characterized by its invasiveness, recurrence, early metastasis and other malignant biological behavior.