颌骨巨细胞瘤和巨细胞肉芽肿病变中多核巨细胞性质的探讨

目的 探讨颌骨巨细胞瘤(Giant cell tumor，GCT)和巨细胞肉芽肿(Giant cell granuloma，GCG)病变中多核巨细胞(Multinucleated giant cells，MGCs)的性质及组织来源。方法 对8例颌骨GET和8例GCG(中心性4例、外周性4例)进行酶组织化学和免疫组织化学观察，并与其它含MGICs的口腔病变(如异物反应、淋巴结结核等)进行比较。结果 颌骨GCT和GCG中的MGCs既可表达组织细胞／单核巨噬细胞相关抗原如CD68、αl-抗胰蛋白酶(Alpha-1-antitrypsin，AAT)、α1-抗糜蛋白酶(Alpha-1-antichymotrypsin，AACT)、溶菌酶等]，又具有破骨细胞特异性酶-抗酒石酸酸性磷酸酶Tartrate-resistant acid phosphatase(TRAP)]的活性，但不表达增殖细胞标记Ki-67抗原。结论 颌骨GCT和GCG中的MGCs可能是反应性终末分化细胞，由病变中处于不同分化阶段的前体破骨细胞融合而成．同时具有单核巨噬细胞和破骨细胞的某些表型特征。

Nature of multinucleated giant cells in giant cell tumor and giant cell granuloma of the jaws

Objective To investigate the possible nature of the multinucleated giant cells (MGCs) in giant cell tumor (GCT) and giant cell granuloma (GCG) of the jaws.Methods Eight cases of GCT and 8 cases of GCG 4 central cases (CGCG) and 4 peripheral cases (PGCG)],1 case of scrofula and 1 case of foreign body giant cell granuloma were undergone immunohistochemical staining to detect CD68, AAT,AACT,lysozyme,MAC-387,vimentin,S-100 and Ki-67 using formalin-paraffin embedded tissue sections.Enzyme histochemical staining for tartrate-resistant acid phosphatase (TRAP),an enzyme marker for osteoclasts,was also performed in all cases.Results MGCs in GCT and GCG lesions possessed both histiocyte/monocyte related antigens (CD68,AAT,AACT) as well as osteoclast specific enzyme (TRAP).Ki67 staining,however,showed that only mononuclear cells,but not the MGCs,were in cell cycle.Conclusion The MGCs in GCT and GCG appeared to express both macrophage and osteoclast associated phenotypes.The exclusively proliferative activity demonstrated in the mononuclear cells and the similar immunocytochemical and histochemical expression in some of the mononuclear elements suggest that these cells may represent precursors of the MGCs.Coalescence or fusion of these precursor cells could result in giant cell formation in the lesion.