CD34抗原在脂肪组织肿瘤中的表达及其病理意义

目的：研究CD34在脂肪组织中的表达并探讨其临床病理意义。方法：对11例脂肪瘤、4例血管脂肪瘤、4例血管平滑肌脂肪瘤、1例梭形细胞脂肪瘤和8例脂肪肉瘤进行CD34免疫组化法检测,观察CD34的表达分布怦况并结合各肿瘤的组织学特征进行分析。结果：除血管内皮细胞均为强阳性外,CD34阳性细胞包括梭形间质细胞和少数多泡状脂母细胞,成熟脂肪细胞为阴性。该抗原在11例脂肪瘤及2例血管脂肪瘤中均为阳性表达,在另2例血管脂肪瘤中为局灶阳性,在4例血管平滑肌脂肪瘤中为阴性表达,在梭形细胞脂肪瘤、脂肪瘤样型脂肪肉瘤及2例黏液性脂肪肉瘤中为强阳性表达,在5例去分化脂肪肉瘤中的表达情况多样,1例为完全阴性,1例为完全阳性,另3例存在阴性、阳性及强旨性区域混杂的情况。结论：脂肪组织肿瘤中存在一类CD34阳性的梭形间质细胞,CD34的表达情况可能与去分化脂肪肉瘤的去分化程度相关,该抗原可以作为梭形细胞脂肪瘤与其他梭形细胞肿瘤的鉴别诊断指标之一。

Expression and the clinicopathological significance of CD34 antigen in lipomatous tumors

Purpose To study the expression and the clinicopathlogical significance of CD34 antigen in adipose tissue neoplasms. Methods Eleven lipomas, 4 angiolipomas, 4 angiomyolipomas, 1 spindle cell lipoma and 8 liposarcomas were studied for CD34 expression by immunohistochemistry. Expression of CD34 antigen in lipomatous tumors was analyzed in relation to the clinicopathlogical features. Results Besides the vascular endothelium being positive for CD34 in all the cases studied, spindle interstitial cells and a few of multivacuolated lipoblasts in the stroma appeared positive for this antigen, but the mature adipocytes were CD34 negative. The spindle cells in all cases of lipomas and two cases of angiolipomas showed diffuse staining for CD34. The other two cases of angiolipomas showed focally positivity. The 4 cases of angiomyolipomas were CD34 negative. The spindle cells in spindle cell lipoma and lipoma like liposarcoma and myxoid liposarcomas showed diffuse strong positivity for this antigen. In 5 cases of dedifferented liposarcomas, one was negative, one was positive, and the other three displayed variable positivity in different areas. Conclusions There may exist a population of CD34 positive spindle interstitial cell in lipomatous tumors. Expression of CD34 antigen may indicate the "dedifferented" degree of the dedifferented liposarcomas and it is of great value in the diagnosis of spindle cell lipoma and other spindle cell neoplasms.