应用组织芯片技术研究A103和inhibin α在肾上腺皮质肿瘤中的诊断价值  

Diagnostic value of A103 and inhibin-α in adrenocortical tumors: an immunohistochemical study using tissue microarray techniques

作　　者：张红英[1] 王晓洁[1] 刘卫平[1] 蒋莉莉[1] 李甘地[1] 郭嘉[1] 张元亨[2] 

机构地区：[1]四川大学华西医院病理科,成都610041 [2]西南石油学院

出　　处：《中华病理学杂志》2004年第3期203-207,共5页Chinese Journal of Pathology

基　　金：四川省科委重点项目 ( 0 1SG0 13 0 3 );纽约中华医学基金会 (CMB)部分资助 ( 0 0 72 2 )

摘　　要：目的　研究肾上腺皮质肿瘤的免疫组织化学和临床病理特点及A10 3与inhibinα在其中的诊断价值并探讨组织芯片技术的可行性。方法　制备肾上腺皮质腺瘤 (ACA)、肾上腺皮质癌 (ACC)及嗜铬细胞瘤组织芯片各 1个。肾上腺皮脂腺瘤芯片 (79例 ) ,其中正常肾上腺皮质 3例 ,胎儿肾上腺皮质 2例 ,肾上腺皮质结节状增生 2例 ,ACA 72例 ;肾上腺皮质癌芯片 (5 6例 ) ,其中ACC 39例 ,肾上腺转移肿瘤 17例 (恶性黑色素瘤 4例 ,转移癌 13例 ) ;嗜铬细胞瘤芯片 (4 4例 )中含肾上腺髓质 3例 ,嗜铬细胞瘤 4 1例 ;2 0例正常成人肾上腺的常规石蜡组织作对照。用免疫组织化学EnVision法检测A10 3、inhibinα、calretinin、Ki 6 7等的表达情况。结果　A10 3阳性表达情况分别为正常肾上腺皮质10 0 % (2 3/ 2 3) ,胎儿肾上腺皮质 2 / 2 ,皮质增生 2 / 2 ,ACA 90 9% (6 0 / 6 6 ) ,ACC 94 6 % (35 / 37) ,肾上腺髓质及嗜铬细胞瘤阴性 ,转移肿瘤中除恶性黑色素瘤 3/ 3阳性外其余均为阴性 ;inhibinα在正常肾上腺皮质、胎儿肾上腺皮质及皮质增生中 10 0 %表达 ,阳性部位主要在网状带与束状带内层 ,ACA阳性率75 8% (5 0 / 6 6 ) ,ACC 75 7% (2 8/ 37) ,肾上腺髓质、嗜铬细胞瘤及转移肿瘤均为阴性。结论　组织芯片技术为快速原位?Objective To investigate the potential diagnostic value of A103 and inhibin-α in adrenocortical tumors and to evaluate the applicability of tissue microarray/tissue chip in pathological studies using immunohistochemistry. Methods A tissue microarray/tissue chip was constructed to contain 179 formalin-fixed, paraffin-embedded adrenal tissue samples which include 3 normal adrenal cortex, 2 fetal adrenal cortex, 2 nodular adrenocortical hyperplasia samples, 72 adrenocortical adenomas,39 adrenocortical carcinomas, 3 adrenal medulla, 13 metastatic carcinomas, 4 metastatic malignant melanomas and 44 pheochromocytomas. Additional 20 cases of normal adult adrenal gland were used as controls. Immunohistochemical markers,including A103, inhibin-α, calretinin and Ki-67 were used on the tissue array sections by EnVision immunohistochemical staining methods. Results Positive staining of A103 was seen in all of the 23(100%) adrenal cortex, 2 fetal adrenal cortex, 2 nodular adrenocortical hyperplasia samples, 60 of 66 (90.9%) adrenocortical adenomas samples, 35 of 37 (94.6%) adrenocortical carcinomas samples, 3 of 3 malignant melanomas, but in none of the adrenal medulla, pheochromocytomas or adrenal metastatic carcinoma samples. In all of the adrenal cortex, fetal adrenal cortex and nodular adrenocortical hyperplasia cases, inhibin-α immunoreactivity was limited to the zona reticularis and the innermost zona fasciculata. Fifty of the 66 (75.8%) adrenocortical adenomas, 28 of the 37(75.7%) adrenocortical carcinomas were positive for inhibin-α. None of the adrenal medulla, pheochromocytoma, metastatic malignant melanoma or carcinoma samples showed a positive inhibin-α immunostain.Conclusions The tissue microarray/tissue chip technique provides a reliable method to investigate marker expression by offering a rapid, economic and accurate screening of tissue specimens on a large scale. The combined use of A103 and inhibin-α is valuable in distinguishing adrenocortical tumor from pheochromocytoma and other metastatic neoplasm

关 键 词：组织芯片 A103 inhibinα 肾上腺皮质肿瘤 诊断 病理特点 免疫组织化学 

分 类 号：R736.6[医药卫生—肿瘤]