Melan-A和Inhibin α在肾上腺肿瘤鉴别诊断中的作用  

Role of Melan-A and Inhibin α in differential diagnosis of adrenal tumours

作　　者：王辅林[1] 宋欣[1] 李向红[1] 

机构地区：[1]解放军总医院病理科,北京100853

出　　处：《诊断病理学杂志》2004年第5期301-303,I078-I079,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的　研究Melan A和Inhibinα在肾上腺肿瘤鉴别诊断中的作用。方法　 78例肿瘤组织标本 ,包括 5例正常或瘤旁肾上腺组织、17例肾上腺皮质腺瘤、8例肾上腺皮质腺癌、2 3例肾上腺嗜铬细胞瘤、13例肝细胞癌和 12例肾细胞癌。应用PowerVisionTMSystem法检测Melan A和Inhibinα的表达。结果　Melan A在正常或瘤旁肾上腺组织表达阳性率 10 0 % ,肾上腺皮质腺瘤 76 5 % ,肾上腺皮质腺癌 5 0 %。在肝细胞癌和肾细胞癌中均呈阴性表达。In hibinα在正常或瘤旁肾上腺组织表达阳性率 10 0 % ,肾上腺皮质腺瘤 82 4 % ,肾上腺皮质腺癌 75 0 %。Inhibinα在肝细胞癌表达率 2 3 1% ,肾细胞癌 16 7% ,肾上腺嗜铬细胞瘤呈阴性表达。结论　MelanObjective To investigate the potential differential diagnosis role of Melan-A and Inhibin α in adrenal tumors. Methods 78 cases of formalin-fixed, paraffin-embedded tissue from 5 normal adrenal or adjacent tumor adrenal tissues, 17 adrenocortical adenomas, 8 primary adrenocortical carcinomas, 23 pheochromocytomas, 13 hepatocellular carcinomas and 12 renal cell carcinomas were prepared. The expession of Melan-A and Inhibin α antibodies were detected with PowerVision TM System immunohistochemical staining method. Results 5/5 (100%) normal adrenal or adjacent tumor adrenal tissues, 13 of 17 (76.5%) adrenal adenomas and 4 of 8 (50%) adrenal cortical carcinomas were reactive with Melan-A. The cytoplasmic reactivity for Melan-A in normal or adjacent tumor tissues, which showed granular in areas of zona glomerulosa, zona fasiculata and zona reticularis, was expressed, whereas the staining pattern in adrenal tumors was coarsely granular and most commonly in clear cell areas. 5/5 (100%) normal adrenal or adjacent tumor adrenal tissues, which expressed predominantly in zona reticularis and the internal layer of zona fasiculata showed cytoplasmic or membranous positive pattern for Inhibin α. The laternal layer of zona fasiculata, zona glomerulosa and adrenal medullary were negative for Inhibin α. 14 of 17 (82.4%) adrenal adenomas and 6 of 8 (75%) adrenal cortical carcinomas were reactive for Inhibin α, and the staining pattern was either cytoplasmic or membranous granular both in clear-cell and granular cell areas. None of the pheochromocytomas, hepatocellular carcinomas and renal cell carcinomas reacted with Melan-A. Moreover, all pheochromocytomas were also negative reaction for inhibin α. The expression of inhibin α in hepatocellular carcinoma and renal cell carcinoma was 23.1% and 16.7%, respectively. Conclusions Melan-A and Inhibin α are useful markers in differential diagnosis of adrenal tumors.

关 键 词：Inhibinα 表达率 肾上腺皮质腺瘤 肾上腺皮质腺癌 肾上腺组织 正常 肾上腺肿瘤 标本 阳性率 

分 类 号：R736.6[医药卫生—肿瘤] R737.11[医药卫生—临床医学]