SUBSTANTIATION OF THE SURGICAL TREATMENT OF PATIENTS WITH PLEOMORPHIC ADENOMAS OF SALIVARY GLANDS
DOI:
https://doi.org/10.35220/2078-8916-2020-38-4-48-53Keywords:
pleomorphic adenoma of salivary glands, mi-croRNA, extracapsular dissection, parotidectomyAbstract
Introduction. The pleomorphic adenoma (PA) is the most common benign tumor of salivary glands (60-90 %). The morphological, immunohistochemical, genetic study methods are applied for establishment of the final diagno-sis at the postoperative stage. The latter method is the most advanced and allows to detect changes in the mor-phologically intact tissue surrounding the tumor. The surgical treatment of the patients with PA of salivary glands involves the removal of tumor with the surround-ing salivary gland – from 2-3 mm to 2 cm respectively. Such an extensive range of reserve when removing the tis-sue of the intact gland with the tumor is attributed to the peculiarities of the PA capsule, multicenter growth, sig-nificant frequency of relapses. Thus, there is no scientific evidence of the answer to the following question: why it is necessary to remove not only the tumor, but the intact sal-ivary gland and to what extent.
The aim of the study – determination and substantiation of the resection margin of the intact gland in surgeries on PA of the parotid salivary glands.
Materials and methods. 27 patients with pleomorphic ad-enoma of the parotid salivary gland participated in the study. All patients were surgically treated with 3 methods – extracapsular dissection of the tumor, partial superfi-cial parotidectomy, superficial parotidectomy. The total RNA was isolated from the salivary gland tissue by means of phenol-chloroform extraction method, the concentra-tion and the purity of RNA was measured by means of ND1000 spectrophotometer. The expression of 34а and 29а microRNA was evaluated by means of real-time re-verse transcription and quantitative polymerase chain re-action.
The study results. The greatest expression of 34а and 29а of microRNA has been observed in the adjacent to the tu-mor capsule gland tissue at a distance of 5 mm – 1096,91±413,82 and 108,05±64,54 respectively, and the smallest one – in the intact gland which was not adjacent to the tumor and was located at 10 mm of the tumor – 47,5±32,01 and 8,33±4,8 respectively.
Conclusion. The most common surgery on pleomorphic adenomas of the parotid glands is the extracapsular dis-section of the tumor – 70,37 % of patients. The resection of 10 mm intact tissue of the salivary gland adjacent to the tumor is genetically substantiated when conducting the extracapsular dissection and partial superficial parotidectomy of the PA of the salivary glands.
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