卵巢上皮性肿瘤的神经内分泌分化及其机制初探

目的 初步探讨卵巢上皮性肿瘤神经内分泌分化及其机制.方法 应用免疫组织化学SP法、双重免疫组织化学SAP法检测79例卵巢上皮性肿瘤和22例人正常卵巢组织嗜铬素A(CgA)、突触素(Syn)及CgA/上皮细胞膜抗原(EMA)表达,应用图像分析仪定量分析其表达情况.结果 (1)卵巢上皮性肿瘤中CgA表达阳性率59.4%,Syn表达阳性率65.36%,在恶性肿瘤其表达与临床分期及组织分级有关(P＜0.01);明显高于正常卵巢组(P=0.000,＜0.01),正常卵巢组织见少量的神经内分泌细胞(NECs),卵巢上皮性肿瘤NECs数量及染色强度均高于正常卵巢组(P＜0.05);(2)卵巢上皮性肿瘤组织中可见CgA/EMA双重表达的细胞.结论 卵巢上皮性肿瘤的神经内分泌分化是肿瘤异质性的表现之一,卵巢上皮性肿瘤中存在着可向上皮和/或向神经内分泌分化的"多向分化细胞",提示卵巢上皮性肿瘤的神经内分泌分化可能是上皮细胞恶性转化过程中多向分化的结果.

Preliminary study of neuroendocrine differentiation and its mechanism in ovarian epithelial tumors

Objective To investigate neuroendocrine differentiation and its mechanism in ovarian epithelial tumors.Methods Neuroendocrine(NE) cells were identified by immunohistochemiscal staining for chromogranin A and synaptophysin in 79 cases of ovarian epithial tumor and 22 cases of normal ovary.Double-labeling technique was used for simultaneous detection of CgA and epithelial membrane antigean(EMA),and the staining intensity was quantitatively evaluated using an image analysis system.Results The positive staining rate for CgA and SYN in ovarian epithelial tumors was 59.4% and 65.36%,respectively,which was higher than that in normal ovary(P=0.000),in which numerous NE cells were found.Both the number and staining intensity of NE cells in ovarian epithelial tumor were increased as compared with normal ovary.Cells co-expressing CgA and EMA were detected in the ovarian epithelial tumors.Conclusion The presence of NE cells in ovarian epithelial tumor suggests heterogeneity of the tumors,and the occurrence of "multidirectional differentiation cells" within the these tumors indicates that NE cells might derive from malignant cells with multidirectional differentiation capacity.