CD99在软骨母细胞瘤中的表达及其意义

目的探讨CD99在软骨母细胞瘤的表达。方法 应用免疫组织化学S-P法，观察l2例软骨母细胞瘤的病理形态。结果 12例软骨母细胞瘤中9例CD99阳性，在无基质的软骨母细胞和部分网状基质内软骨母细胞处表达，基质明显区和钙盐沉积处的软骨母细胞和软骨细胞均阴性。S-100蛋白、Vim、NSE弥漫强阳性，多核巨细胞CD68阳性。结论CD99对软骨母细胞瘤阳性无特异性诊断价值。联合应用CD99、S-100蛋白和Vim等标记，进一步说明软骨母细胞瘤是由胚胎性软骨母细胞发生。     

鼻腔小细胞恶性肿瘤26例临床病理分析

目的 探讨鼻腔小细胞恶性肿瘤的病理形态学和免疫组化染色的特点.方法收集26例鼻腔小细胞恶性肿瘤,通过常规HE及免疫组化染色进行观察.结果 恶性黑色素瘤11例,可见突出的嗜酸性核仁、核沟、核内假包涵体,表达S-100蛋白、HMB-45、Melan-A.嗅神经母细胞瘤7例,可见神经原纤维、菊形团结构,NSE、Syn阳性,S-100蛋白在肿瘤周边的支持细胞中表达.横纹肌肉瘤4例,瘤细胞多嗜酸性,desmin、vimentin、MyoDl、Myogenin阳性.小细胞神经内分泌癌2例,可见较多的凋亡、坏死和出血,NSE、Syn、CgA均阳性.骨外Ewing肉瘤/原始神经外胚层肿瘤2例,可见Homer-Wright假菊形团及乳头状结构,CD99、vimentin、Syn、NSE均阳性.结论 鼻腔小细胞恶性肿瘤具有相似的临床和形态学表现,因此,只有根据其各自的形态学和免疫组化染色特点,才可做出正确的诊断及鉴别诊断.     

神经母细胞瘤骨髓转移23例临床病理分析

目的 探讨神经母细胞瘤骨髓转移的临床病理特征.方法 对23例神经母细胞瘤骨髓转移的临床病理资料进行分析,并做光镜观察及免疫组化染色.结果 神经母细胞瘤骨髓转移表现为微小浸润、中度浸润和弥漫浸润三种形式,主要根据骨髓造m组织与肿瘤成分的比例和分布而定,其中微小浸润常需行CgA/NSE免疫组化染色辅助诊断.结论 神经母细胞瘤骨髓转移的诊断需结合临床、光镜及免疫组化,以提高检出率并鉴别于横纹肌肉瘤、骨Ewing肉瘤、淋巴母细胞淋巴瘤/白血病.     

原发性肺癌的神经内分泌分化及临床意义

选择32例放疗、化疗后具有完整随访资料的肺癌患者,对其支气管镜活检标本应用,神经特异性烯醇化酶(NSE)、铬粒素A(CGH-A)、癌胚抗原(CEA)、角蛋白(K)进行免疫组化ABC法染色。结果,小细胞肺癌(SCLC)NSE和(或)CGH-A阳性率(6/14)44.4％。阳性者中位生存时间(21月)长于阴性者(12月),非小细胞肺癌中(NSCLC)中亦有2/18例NSE阳性,其生存时间短于阴性者中位生存时间,两类型肺癌CEA阳性及阴性者缓解率与中位生存均无明显差异。结论:(1)各类型肺癌均有NE分化。(2)具有神经内分泌分化(尤其CGH-A阳性)的SCLC患者存活时间长,临床预后较好,而NSE阳性的NSCIC较阴性者生存时间短、预后差。(3)CEA对肺癌患者的临床预后判断无明显意义。     

抗人脑神经元特异性烯醇化酶(NSE)单克隆抗体杂交瘤细胞株Ly-1的建立

神经元特异性烯醇化酶,简称NSE,是肺小细胞癌(SCLC)和儿童神经母细胞瘤高特异性的血清学标志物。NSE可用来鉴别SCLC和非小细胞癌(NSCLC),评价治疗反应,预报复发。做为一个十分有用的肿瘤标志,NSE已被用于临床病例分析。我们自人脑分离纯化出高纯度NSE抗原,免疫BA-     

婴儿色素性神经外胚瘤1例报道并文献复习

目的 探讨婴儿色素性神经外胚瘤的临床病理特征、免疫组化、诊断和鉴别诊断要点。方法 对1例婴儿色素性神经外胚瘤进行组织学和免疫组化观察和文献复习。结果 婴儿色素性神经外胚瘤好发于1岁以内的婴儿,肿瘤多见于上颌骨和颅骨,表现为浸润性和溶骨性破坏。组织学上显示大的并含不等量色素颗粒的上皮样细胞和小的神经母细胞样细胞。免疫组化显示CK、HMB-45、S-100蛋白、NSE在上皮样细胞呈阳性表达,小圆形瘤细胞S-100蛋白、NSE阳性或部分阳性。肿瘤彻底切除,随访3年未发现转移和复发。结论 婴儿色素性神经外胚瘤是一种少见的起源于神经嵴细胞的肿瘤,具有特征性的临床病理改变,需要和神经母细胞瘤、恶性黑色素瘤及其它小圆细胞肿瘤鉴别,生物学行为属于潜在恶性或低度恶性肿瘤,彻底切除预后良好。     

ELISA法检测肿瘤相关抗原神经元特异性烯醇化酶的方法学评价

对肿瘤相关抗原神经元特异性烯醇化酶(NSE)ELISA检测方法进行综合评价.选择临床诊断为小细胞肺癌、非小细胞肺癌及神经母细胞瘤等肿瘤患者、其它非肺癌肿瘤患者、良性疾病患者及健康人样本共223例,进行盲法比较.本方法的灵敏度为60.2%,特异性为93.8%,阳性预测值为87.5%,阴性预测值为76.7%.NSE在各入选人群中的阳性率分别为:小细胞肺癌组84.6%,非小细胞肺癌组47.6%,肺癌组总阳性率为58.4%,神经母细胞瘤组阳性率为100%,非肺癌肿瘤组的阳性率为13.3%,良性疾患组阳性率为0%,健康人群组阳性率为0%.中国正常人群cut-off值为7.78μg/L,与试剂盒提供的cut-off值相似.NSE在小细胞肺癌及神经母细胞瘤患者中有很高的阳性率,尤其是对于神经母细胞瘤有很高的临床意义.NSE在正常健康人及良性疾病患者、非肺癌肿瘤患者中的阳性率较低,检查NSE有助于肿瘤的鉴别诊断.     

21例腺泡状软组织肉瘤的临床病理分析

目的探讨腺泡状软组织肉瘤的临床病理学特征及其鉴别诊断。方法对21例ASPS的临床资料进行回顾性分析,对标本进行组织病理学观察及免疫组织化学研究。结果21例腺泡状软组织肉瘤,男性11例,女性10例,发病年龄4～56岁,平均25.9岁,发病部位主要位于下肢深部软组织内,镜下肿瘤细胞排列成腺泡状或实性,细胞巢之间可见窦状血管分隔,瘤细胞胞质内含丰富的嗜酸性颗粒。PAS染色,瘤细胞胞质内可见棒状结晶体,免疫组化:MyoD110例阳性,desmin4例阳性,S-1009例阳性,NSE11例阳性,Vim11例阳性,AE1/AE3、CK、EMA、SMA、MSA、Syn全部为阴性。结论ASPS是多见于青少年和青年的罕见肿瘤,但多数早期出现血液转移,切除后易复发,最终预后欠佳,结合临床病理学特征及免疫组化,可作出正确诊断。     

外周原始神经外胚叶瘤/尤因肉瘤临床病理学

目的:研究原始神经外胚叶瘤(PNET)/尤因肉瘤的(EWS)的诊断、鉴别诊断.方法:41例病人按传统病理学分为3类,并用免疫组织化学两步法检测CD99、NSE、S-100蛋白、Syn、Vim、LCA、Des、Myo抗体的表达.结果:(1)41例病人有27例PNET,8例EWS和6例Askin瘤.(2)免疫表型:CD99有87.8%强阳性表达,NSE 53.7%,S-100蛋白22%,Syn 4.9%,vim 41.5%,统计结果显示CD 99强阳性表达与NSE、S-100蛋白、Syn、Vim强阳性表达差异有显著性(P<0.01).(3)PNET、EWS、Askin瘤对各种抗体的阳性表达差异无显著性(P>0.05).结论:(1)PNET、EWS、Askin瘤属同一肿瘤家族.(2)用组织学、免疫组织化学可与其他小圆细胞肿瘤进行鉴别诊断.     

鼻腔鼻窦畸胎癌肉瘤与嗅神经母细胞瘤的对比观察

目的 总结鼻腔鼻窦畸胎癌肉瘤(SNTCS)的临床病理特征、诊断和鉴别诊断要点以及嗅神经母细胞瘤(ONB)的临床病理特点,探讨SNTCS与ONB的关系及其组织来源.方法 对7例SNTCS和34例ONB的临床病理情况及免疫表型进行了观察,并对照观察了1例未成熟型恶性畸胎瘤及1例妊娠8周胚胎组织的形态学及免疫表型特点.结果 SNTCS男6例,女1例,平均年龄46岁.7例中3例为复发病例.组织病理学特征:肿痛由多种组织成分构成,这些成分源自3个胚层,是畸胎瘤样成分和癌肉瘤的混合,畸胎瘤样成分包括外胚层幼稚的鳞状细胞巢,内胚层的腺体和管状结构、纤毛柱状上皮,中胚层的纤维细胞、软骨、骨样基质、横纹肌及平滑肌组织;癌成分主要包括腺癌、鳞状细胞癌成分,肉瘤成分主要为横纹肌肉瘤、平滑肌肉瘤和纤维肉瘤成分,另外可见ONB成分、类癌及原始间叶组织.免疫组织化学染色:上皮及向上皮分化的组织表达广谱细胞角蛋白(CKpan)及上皮细胞膜抗原(EMA);ONB成分不同程度地表达突触素(Syn)、神经元特异性烯醇化酶(NSE)、CD99、神经丝蛋白(NF)及嗜铬粒素A(CgA),S-100蛋白神经丝束阳性.真菊形团表达CKpan及EMA;梭形细胞成分表达波形蛋白、平滑肌肌动蛋白(SMA)、结蛋白、肌球蛋白、肌红蛋白.原始间叶组织表达波形蛋白.黏液样物质和糖原颗粒PAS阳性.7例肿瘤细胞胶质纤维酸性蛋白(GFAP)均为阴性.ONB 34例,男18例,女16例,平均年龄42.8岁.形态学特征是:分叶状上皮团巢,血管襻网隔,小圆小梭形细胞,异向分化的腺样、鳞状上皮样细胞及横纹肌母细胞,菊形团,神经丝束,深染的细胞核,少、粉染或透明的胞质.免疫组织化学染色:NSE及CgA在小细胞100%表达,但在不同病例表达程度不同,S-100蛋白在神经丝处100%表达,CKpan在鳞状及腺样分化的细胞100%表达,肌红蛋白表达于横纹肌母细胞分化的细胞.未成熟型恶性畸胎瘤内可见原始神经组织,有神经管结构及大片的神经胶质细胞(GFAP阳性).未发现幼稚的非角化透明鳞状细胞巢.1例胚胎组织鼻腔、口腔可见衬覆非角化透明鳞状细胞.结论 SNTCS是罕见的高度恶性肿瘤,多数ONB为低级别的恶性肿瘤.SNTCS成分复杂,形态多样,取材不充分可能导致误诊.未发现SNTCS为生殖细胞来源肿瘤的证据,将SNTCS命名为鼻腔鼻窦畸胎样癌肉瘤可能更好,其组织发生可能为嗅/鼻腔鼻窦黏膜中的原始全能细胞,与ONB的关系有待于进一步的研究和证实.     

Sarcomas of the uterus: immunohistochemical characterization and diagnosis]

Pathologic findings and immunohistochemical characterizations of 18 cases of uterine sarcomas were studied. In endometrial stromal sarcoma (ESS), 5 out of 10 cases had ovarian sex cord-like pattern and 4 out of 10 cases had smooth muscle differentiation. Immunohistochemical findings showed vimentin, desmin and cytokeratin positive in 9/10, 6/10, 2/10 cases respectively which reflects that ESS may differentiate into both epithelium and muscle components morphologically. In malignant mixed Mullerian tumors (MMT), its carcinomatous structure may be positive about vimentin, and its sarcomatous structure may be positive to the epithelium markers, which indicates that both the sarcoma and carcinoma structures have possibly a common origin. It is considered to be of value for the diagnosis of MMT, if the tumor has differentiated both epithelium and mesoderm components or to be positive to myoglobin, NSE* in immunoreaction, accompanying with the morphologic characterizations of the tumor.     

Role of immunocytochemistry and DNA flow cytometry in the fine-needle aspiration diagnosis of malignant small round-cell tumors

In the present study, DNA flow cytometry (FCM) and immunocytochemistry (ICC) with a selected panel of antibodies were performed on 51 cases of malignant tumors which were referred for fine-needle aspiration biopsy (FNAB) to our Department of Cytology for the last 2 yr. Twelve cases were diagnosed as neuroblastoma, 16 as Ewing's sarcoma, 2 as retinoblastoma, 5 as non-Hodgkin's lymphoma (NHL), 5 as rhabdomyosarcoma, 2 as peripheral neuroectodermal tumors (PNETs), and 8 as Wilms' tumor. Eleven of 12 neuroblastomas were diploid by FCM, and 1 was aneuploid, with an S-phase fraction (SPF) of 8.3%. Neuron-specific enolase (NSE) was negative in 3 and positive in 8 cases of neuroblastoma, whereas neuroblastoma marker was positive in 3/11. Sixteen of 17 Ewing's sarcomas were diploid, and 1 showed tetraploid aneuploidy, with an SPF of 10.06%. Eight of 13 Ewing's sarcomas were positive for Mic-2 gene product (Ewing's marker). All 5 NHL were positive for leukocyte-common antigen (LCA). Three of 5 rhabdomyosarcomas were diploid, and 2 cases showed aneuploidy. Rhabdomyosarcoma showed muscle-specific actin positivity in 4 and desmin positivity in 3 cases. All 3 cases of PNET were diploid and positive for the Mic-2 gene product, whereas NSE and vimentin were positive in 2 cases. Both cases of retinoblastoma were diploid. Immunostaining was noncontributory in 1 case, and the other showed positivity for the retinoblastoma gene product, NSE, and chromogranin. Seven of 8 Wilms' tumors were diploid, and 1 showed aneuploid, with an SPF of 11.13%. Seven of 8 Wilms' tumors were positive for cytokeratin (CK), 5 were positive for NSE, 6 were positive for epithelial membrane antigen (EMA), and 5 were positive for vimentin. FNAB diagnosis of malignant round-cell tumors is difficult only by light microscopy. Due to the availability of specific markers for subgrouping tumors, ICC has proved to be more useful these days, while DNA FCM has little diagnostic value, as most of them are diploid. Further ancillary studies, e.g., electron microscopy, image analysis, and other molecular investigations, are required to further categorize these tumors more precisely for better clinical management of these cases.     

Malignant peripheral neuroectodermal tumours of childhood and adolescence

Summary Seventeen cases of malignant peripheral neuroectodermal tumour (MPNT) were studied by means of light microscopy, immunohistochemistry and electron microscopy. There were nine males and eight females. The mean age of the 17 patients was 10 years with a range of seven months to 20 years. The vast majority of tumours was located in the trunk. Histologically, they closely resembled Ewing's sarcoma, although minor differences were obvious. Special findings included ganglion cells and Flexner rosettes. In 10/11 cases positive staining for neuron-specific enolase (NSE) was obtained. Five of 10 tumours were positive for protein S-100. Three contained vimentin, two neurofilaments and one vimentin, neurofilaments and GFAP. Neurosecretory granules were noted in the three cases studied. Five patients died, three are alive with disease and five patients are alive without evidence of disease. It is concluded that these tumours form a homogeneous group, although the grade of differentiation varies. The prognosis in most cases is poor. Distinction from Ewing's sarcoma is possible by staining for NSE and by electron microscopy.This study was supported in part by a grant from the Bundesminister für Arbeit und Sozialordnung     

肺原发性软骨肉瘤2例及文献复习

目的：探讨肺原发性软骨肉瘤的临床病理特征及组织发生。方法：通过ＨＥ、组化及免疫组化观察２例肺原发性软骨肉瘤,并复习文献。结果：肿瘤由粘液亲基质和疏网状结构的梭形细胞及软骨母细胞组成,例２还存在幼稚小圆细胞,三种细胞梯度移行。组化染色显示ＡＢ（ｐＨ２．５）、ＴＢ（ｐＨ４．０）阳性。免疫组化染色显示梭形细胞及软骨母细胞Ｓ－１００蛋白、ｖｉｍｅｎｔｉｎ和ＮＳＥ阳性,例２Ｓｙｎ阳性。小圆细胞ＣＤ９９、Ｓ－     

Neuron-specific enolase-producing leiomyosarcoma of the mesentery

A case of neuron-specific enolase (NSE)-producing leiomyosarcoma arising in the mesentery of a 62-year-old female is presented. Preoperatively, serum level of NSE was markedly elevated. A well-defined but unencapsulated tumor measuring 14 x 12 x 9 cm was histologically characterized by a fascicular or herring-bone arrangement of atypical spindle or oval tumor cells with vesicular cigar-shaped nuclei, inconspicuous nucleoli and abundant clear to brightly eosinophilic cytoplasm. Immunohistochemically, the tumor was positive for vimentin, alpha-smooth muscle actin, muscle actin, desmin, and gamma-NSE. Postoperatively, serum level of NSE decreased to within normal range. The NSE levels were, however, elevated again as metastatic lesions in the liver had enlarged. The patient died of the liver metastases 10 months after surgery. Serum NSE level can be a useful index of tumor extent and for monitoring treatment of some patients with leiomyosarcoma.     

黄芩甙体外诱导大鼠骨髓基质细胞成为神经细胞

目的:探讨黄芩甙体外诱导成年大鼠骨髓基质细胞(MSCs)分化为神经细胞的条件。方法:采用黄芩甙诱导6h后,继续维持诱导6d。免疫细胞化学染色评价神经细胞特异性烯醇化酶(NSE)、神经微丝(NF)、胶质纤维酸性蛋白(GFAP)和波形蛋白(vimentin)的表达率;Hoechst33258染色评价细胞存活率。结果:诱导6d后MSCs形态改变,胞体成锥形,突起交织成网。免疫细胞化学染色NSE、NF、GFAP和vimentin表达率分别为70.5%±11.6%,68.3%±13.4%,＜1%,＜1%,细胞存活率为88.4%±5.0%。结论:黄芩甙可以诱导成年大鼠MSCs在体外分化成为神经细胞,该方法将为神经系统细胞移植和基因治疗提供新的思路。     

消化道小细胞癌的临床病理分析

目的 研究消化道小细胞癌临床病理和免疫表型特征。方法 对17例消化道小细胞癌作了临床病理形态学观察和免疫组织化学检测。结果光镜形态分为3型：小细胞型8例，中间细胞型4例，混合型5例。免疫表型：EMA12例、NSE10例、keratin9例、CgA6例、S-100蛋白3例呈阳性，vimentin均阴性。结论 EMA、NSE、keratin为小细胞癌的较为可靠的标记物，支持此瘤来源于内胚层全能干细胞。     

Adenoid cystic carcinoma of the breast: a histologic, cytologic, and immunohistochemical study

Six cases of adenoid cystic carcinoma (ACC) of the breast were reviewed. Immunohistochemical studies were carried out for actin, S-100 protein, EMA, keratin, CEA, vimentin, NSE, alpha-lactalbumin, and lysozyme. Fine needle aspiration biopsy smears of five patients were also reexamined. Patients were treated by tumorectomy, quadrantectomy, or modified radical mastectomy. Axillary dissection was carried out in five cases, with negative lymph nodes in all. Five patients are alive without evidence of disease from 1 year 10 months to 13 years 4 months following surgery. One patient died 7 1/4 years after mastectomy, without evidence of disease. Histologically, a diagnostic biphasic cellular pattern was seen in all cases. In addition, several unusual features were encountered in some cases: squamous metaplasia, stromal myxoid pseudocartilaginous foci, and well-formed neoplastic ducts. Actin and/or S-100 protein were variably positive in all cases. The reaction was usually present in occasional basaloid cells predominantly at the periphery of neoplastic structures. Keratin, EMA, and CEA immunostaining disclosed ductal type cells in all cases. Vimentin was positive in four cases, usually in many basaloid cells. Aspiration cytology was suspicious in two cases and yielded a definitive diagnosis of ACC in three cases. Cytologic diagnosis was based on cellular morphology and on the presence of characteristic globoid structures. Immunohistochemical results show that in ACC dual myoepithelial-ductal differentiation occurs but is relatively limited. Most of the tumor cells are not differentiated ("indifferent" cells) and often express strong vimentin positivity. Such cells are regarded as precursor cells for either differentiated element. Unusual metaplastic changes in breast ACC suggest a possible relation with pleomorphic adenoma-type tumors, and this might be of prognostic significance.     

Cytogenetic abnormalities of alveolar soft-part sarcomas using interphase fluorescent in situ hybridization: trisomy for chromosome 7 and monosomy for chromosomes 8 and 18 seem to be characteristic of the tumor

Four alveolar soft-part sarcomas were investigated by means of standard immunohistochemistry and interphase cytogenetics to further characterize the immunophenotype and proliferative activity of this tumor. The main goal of this study was to explore the chromosomal changes of this rare soft-tissue sarcoma. One epithelial (KLI), three neurogenic [neuron specific enolase (NSE), PGP 9.5, and S100], and five myogenic (desmin, myoglobin, alpha-smooth mnuscle actin, alpha-sarcomeric actin, and MyoD1) markers were used for the immunophenotypical analysis. Proliferative activity was assessed using the Ki67 index. Twelve (peri)centromeric (1, 3, 4, 6, 7, 8, 10, 12, 15, 17, 18, and X) and one telomeric (17q25-qtel.) chromosomal probes were used for interphase cytogenetic analysis. Three of the cases showed cytoplasmic desmin and/or myoglobin, and one showed smooth muscle actin positivity. All of the four tumors had granular, cytoplasmic, possibly nonspecific MyoD1 and sarcomeric actin positivity. Two of the tumors were positive for vimentin, four gave focal and weak staining with neurogenic markers (four of four NSE, one of four S100, and four of four PGP 9.5), but none of them was positive with KLI. Alveolar soft-part sarcomas may show myogenic immunophenotype in a number of cases, which supports myogenic differentiation. Fluorescent in situ hybridization using alpha satellite chromosomal probes revealed significant alterations in all of the cases. Most frequent and repeated numerical changes, which seem to be characteristic of the neoplasm and may play an important part in its pathogenesis and/or progression, were trisomy 7, monosomy 8 and monosomy 18.     

Reciprocal/dichotomic expression of vimentin and B cell differentiation antigens in Reed-Sternberg's cells

Summary An immunohistochemical study of 63 cases of Hodgkin's disease was undertaken using formalin-fixed paraffin embedded tissue sections. The antibodies used were against L26, LN-1, LN-2, EMA (epithelial membrane antigen), Leu-M1, Vimentin, UCHL-1, S-100, and lysozyme. Hodgkin's disease could be divided into three groups: the first group was LN-1+/L26+/vimentin-, the second LN-1-/L26+/vimentin+, and the third LN-1-/L26-/vimentin+). Sixteen cases of follicular lymphomas were also examined and were all positive for LN-1 and L26 and negative for vimentin. Thus the vimentin negativity of the first group, including 7 nodular lymphocyte-predominant cases, gives further evidence of their germinal center B-cell origin. Since vimentin is expressed mainly in the immature stage of B-lymphocytes, the second group of Hodgkin's disease may represent immature B-cell Hodgkin's disease. In the third group, vimentin was present in Reed-Sternberg's (RS) and Hodgkin's (H) cells in 45 of the 48 cases (92.5%). In none of 48 cases were these cells positive for S-100 or lysozyme, but strong vimentin-positivity still suggested monocytic or histiocytic origin. The results of our study suggest, at least, divergent origin of RS's and H's cells.