Clinical Significance Of Pathological Reclassification In 65 Cases Of Alveolar Cell Carcinoma Of Salivary Gland By The 2017 Edition WHO Classification

Objectives According to the new standard for classification of GHO salivary gland tumors in 2017(4th edition),65 cases of adenocarcinoma diagnosed according to the 2005 WHO salivary gland tumor classification standard(3rd edition)were reclassified.Therefore,we can deepen the understanding of the new solid tumor secretory cancer in the new classification of salivary gland tumor,and provide accurate pathological diagnosis basis for the clinical diagnosis and treatment of secretory cancer.Methods From January 2013 to December 2016,65 cases of adenocarcinoma were diagnosed according to the 2005(3rd edition)WHO salivary gland tumor classification standard,and the patient’s sex was recorded in detail.,age,tumor size,pathological staging,recurrence and metastasis in 1 year and 3 years after surgery.According to the new diagnostic standard of WHO salivary gland tumor in 2017(4th edition),it was reclassified with the results of tissue morphology,immunohistochemical staining,and fluorescence in situ hybridization.The classification results were in line with 7 cases of secretory cancer and 58 cases of adenocarcinoma.The clinicopathological features of the two groups were compared and analyzed.Results 1 Secretory carcinoma is very similar in histology to adenocarcinoma,including solid,lobed,microcystic,glandular tubular,sieve,or papillar-cystic structures,in which papillar-cystic structures are secreted.Carcinoma is more common.Mammaglobin positive,S-100 positive and DOG-1 negative for immunohistochemical staining secreting monoclonal cancerous antibodies,in contrast to adenocarcinoma.Fluorescence in situ hybridization(FISH)detection of secretory cancer has t(12;15)(p13;q25)Chromosome translocation,manifested as ETV6 gene rearrangement,resulting in positive fusion of ETV6-NTRK3 gene.2 The clinicopathological characteristics show that of the 7 cases of secretory cancer,3 were female and 4 were male,aged 24-56 years,with an average age of 42.5 years,a tumor size of 1.3 cm-4.3 cm,and an average diameter of 2.8 cm.Of the 58 cases of adenocarcinoma,53 were female and 5 were male,aged between 24 and 65,with an average age of 44.5 years,a tumor size of between 1.6 cm and 8.5 cm,and an average diameter of 5.1 cm.Comparative analysis of the two groups of cases in gender,age,swelling size,pathological stages,postoperative 3 years of metastasis or relapse and other indicators of statistical significance(P<0.05).Conclusions 1 The morphology of salivary gland secretory carcinoma is very similar to that of adenocarcinoma.According to the histological characteristics,it is difficult to distinguish and diagnose.Combined with immunohistochemical staining and fluorescence in situ hybridization(FISH),the results can be helpful for the diagnosis and differential diagnosis of both.2 The salivary gland secretory carcinoma and adenocarcinoma have similar clinicopathological characteristics,but there are differences in sex,age,tumor size,pathological stage,recurrence and metastasis after 3 years,immunohistochemistry,and molecular genetics.Therefore,it is necessary to classify salivary gland secretory cancer as an independent histopathological type.Figure 11;Table 4;Reference 79.