摘要目的:探讨NR4A3/NOR-1免疫组织化学染色在涎腺腺泡细胞癌鉴别诊断中的价值。方法:收集2004—2020年解放军东部战区总医院病理科涎腺肿瘤组织学标本142例，包括腺泡细胞癌24例、涎腺分泌性癌12例、导管癌14例、腺样囊性癌16例、基底细胞癌3例、黏液表皮样癌13例、肌上皮癌7例、多形性腺瘤15例、沃辛瘤15例、肌上皮瘤8例、基底细胞腺瘤8例、嗜酸细胞瘤7例；另外收集28例涎腺正常组织及2例胰腺腺泡细胞癌做为对照。运用免疫组织化学染色方法检测这些组织学标本中NR4A3/NOR-1的表达情况，并且和DOG1进行对比。结果:（1）NR4A3/NOR-1阳性定位于细胞核，在涎腺腺泡细胞癌中的阳性率为91.7%（22/24），DOG1阳性定位于细胞质和细胞膜，在涎腺腺泡细胞癌中的阳性率为95.8%（23/24），二者阳性率差异无统计学意义（ P=0.551），但是细胞定位不同；（2）NR4A3/NOR-1在涎腺正常组织及其他类型的肿瘤中不表达，而DOG1不仅表达在正常涎腺腺泡细胞的腔面，也可以在涎腺分泌性癌、腺样囊性癌、基底细胞癌、黏液表皮样癌、肌上皮癌及基底细胞腺瘤中表达（ P<0.01）；（3）NR4A3/NOR-1在涎腺腺泡细胞癌诊断中的灵敏度（91.7%）和特异度（100.0%）均较高，联合使用NR4A3/NOR-1和DOG1可将涎腺腺泡细胞癌的诊断灵敏度和特异度提高至100%；（4）NR4A3/NOR-1仅表达在涎腺腺泡细胞癌中，2例胰腺腺泡细胞癌未见表达（ P=0.018）。 结论:NR4A3/NOR-1特异性抗体是涎腺腺泡细胞癌敏感和特异的生物学指标，NR4A3/NOR-1和DOG1是诊断涎腺腺泡细胞癌的理想抗体组合。

abstractsObjective:To investigate the diagnostic role of NR4A3/NOR-1 immunohistochemistry in acinic cell carcinoma (AciCC) of the salivary gland.Methods:A total of 142 tumors were collected from 2004 to 2020 at Nanjing Jinling Hospital, including 24 cases of AciCCs, 12 salivary gland secretory carcinomas,14 salivary duct carcinomas,16 adenoid cystic carcinomas,3 basal cell carcinomas,13 mucoepidermoid carcinomas,7 myoepithelial carcinomas,15 pleomorphic adenomas,15 warthin tumor, 8 myoepithelioma,8 basal cell adenomas, and 7 oncocytomas; 28 normal salivary gland tissues and 2 pancreatic AciCC were also included.Results:NR4A3/NOR-1,a nuclear marker,was positive in 91.7% (22/24) of AciCC of the salivary gland,while DOG1,a membranous and cytoplasmic marker, demonstrated a sensitivity of 95.8% (23/24);there was no significant difference in the overall positive rates( P=0.551), but the stain pattern was different. NR4A3/NOR-1 was negative in normal salivary gland tissues and any other types of tumors in the salivary gland; however,DOG1 showed apical staining in the acinar cells in the salivary gland,as well as salivary gland secretory carcinomas,adenoid cystic carcinomas,basal cell carcinomas,mucoepidermoid carcinomas,myoepithelial carcinomas and basal cell adenomas( P<0.001). NR4A3/NOR-1 showed a high sensitivity(91.7%) and specificity(100%) to identify AciCC of the salivary gland,and in combination with DOG1, the sensitivity increased to 100%. Furthermore, NR4A3/NOR-1 were only positive for AciCC arising from salivary glands but not pancreas(0/2)( P=0.018). Conclusion:NR4A3/NOR-1 is a special and sensitive biomarker for AciCC of salivary glands; combined NR4A3/NOR-1 and DOG1 can be an ideal diagnostic immunohistochemical panel for AciCC.