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目的 :探讨头颈部髓外浆细胞瘤 ( EMP)的组织学特点、临床行为、免疫球蛋白分泌功能与预后的关系。方法 :对 12例头颈部 EMP患者的手术蜡块进行病理观察与免疫组化检测。结果 :12例中 ,低度恶性 ( 级 ) 3例 ,中度恶性 ( 级 ) 3例 ,高度恶性 ( 级 ) 6例 ;免疫组化显示肿瘤均为单克隆性 ,Ig Gκ、Ig Gλ阳性各 6例。除鼻咽部 2例外 ,均接受手术切除加放疗。 、 、 级 EMP 5年生存率分别为 75 .0 %、6 2 .0 %、37.6 % ;Ig Gκ阳性者6 8.5 % ,Ig Gλ阳性者 37.5 % ,两者有显著性差异 ( P <0 .0 1)。结论 :免疫组化检测对头颈部 EMP鉴别诊断有重要作用 ,手术加放疗为有效的治疗手段 ,组织学分级、免疫球蛋白分泌功能对判断其预后有一定价值
Objective: To investigate the histological features, clinical behaviors, immunoglobulin secretion and prognosis of extrahepatic plasmacytoma (EMP) in head and neck. Methods : Twenty-two head and neck EMP patients were examined for pathological changes and immunohistochemistry. Results: Among the 12 cases, 3 cases were low grade (grade), 3 cases were moderate grade (grade), and 6 cases were highly malignant (grade). Immunohistochemistry showed that the tumors were all monoclonal, and Ig GK and Ig G were positive respectively. 6 cases. With the exception of the nasopharynx, surgical resection and radiotherapy were performed. The 5-year survival rates of , , and EMP were 75.0%, 6.0%, and 37.6%, respectively; Ig-Gκ-positive, 6.5%, and Ig-Gλ-positive, 37.5%. There was a significant difference between the two groups (P<0. 0 1). Conclusion : Immunohistochemistry plays an important role in the differential diagnosis of EMP in the head and neck. Surgery and radiotherapy are effective therapeutic methods. Histological grade and immunoglobulin secretion function have certain value in judging its prognosis.