嗜铬细胞瘤组织芯片免疫组化标记的诊断价值分析  

Diagnostic value of immunohistochemical markers in tissue microarray of pheochromocytoma

作　　者：王晓洁[1] 李响[2] 魏兵[1] 张红英[1] 刘卫平[1] 李甘地[1] 李俸媛[1] 郭嘉[1] 唐源[1] 刘柏龄[1] 

机构地区：[1]四川大学华西医院病理科,成都610041 [2]四川大学华西医院泌尿外科,成都610041

出　　处：《临床与实验病理学杂志》2005年第2期164-168,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：四川省科委重点项目 (01SG013 03 );纽约中华医学基金会(00 722)

摘　　要：目的　探讨肾上腺嗜铬细胞瘤组织芯片免疫组化标记的诊断价值。方法　制备肾上腺组织芯片,含样本163例,其中正常肾上腺15例,肾上腺皮质增生2例,嗜铬细胞瘤41例,肾上腺皮质腺瘤72例,肾上腺皮质癌22例,肾上腺转移癌11例。用免疫组织化学EnVision法检测多种免疫标记的表达情况。结果　肾上腺髓质素(adrenomedullin,ADM)阳性率分别为:正常肾上腺髓质100% (5 /5),嗜铬细胞瘤60. 5% (23 /38),肾上腺皮质肿瘤及转移癌呈阴性; CgA:嗜铬细胞瘤阳性率86 .8%(33 /38); Syn:嗜铬细胞瘤阳性率73. 7% (28 /38),肾上腺皮质癌阳性率28 .6% (6 /21),肾上腺皮质腺瘤及转移癌呈阴性;S- 100蛋白:嗜铬细胞瘤支持细胞阳性率47 4% (18 /38);MelanA(A103)和inhibinα在嗜铬细胞瘤呈阴性,但肾上腺皮质及皮质肿瘤高表达。结论　在嗜铬细胞瘤的诊断和鉴别诊断中,必须联合应用ADM、CgA、S- 100蛋白等多种标记。组织芯片技术为快速原位检测提供了有效的手段。Purpose To evaluate the diagnostic role of immunohistochemical markers in the tissue microarray of pheochromocytomas. Methods A series of adrenal gland tissue microarrays were prepared,including 163 cases of formalin-fixed and paraffin-embedded tissues from 15 normal adrenal glands,2 hyperplastic cortices,41 pheochromocytomas,72 adrenocortical adenomas,22 adrenocortical carcinomas and 11 cases of metastatic carcinomas. A set of immune markers were detected by EnVision immunohistochemical staining methods. Results 5 of 5 (100%) adrenal medullae and 23 of 38 (60.5%) pheochromocytomas were positive for adrenomedullin (ADM) while all of adrenocortical tumors and adrenal metastatic carcinomas were negative. 33 of 38 (86.8%) pheochromocytomas also showed immunopositivity for chromogranin A (CgA). Positive staining of synaptophysin (Syn) was seen in 28 of 38 (73.7%) pheochromocytomas and 6 of 21(28.6%) adrenocortical carcinomas. S-100 protein positive sustentacular cells were found in 18 of 38 (47.4%) pheochromocytomas. Almost all of the adrenal cortices and adrenocortical tumors were positive for Melan A (A103) and inhibin α while pheochromocytomas were negative. Conclusions The combined use of multiple makers including ADM,CgA,and S-100 helps distinguish pheochromacytomas from adrenocortical tumors and other metastatic carcinomas. High-throughput tissue microarray offers a powerful strategy for rapid identification in situ.

关 键 词：肾上腺肿瘤 嗜铬细胞瘤 免疫组织化学 肾上腺髓质素 组织芯片 

分 类 号：R736.6[医药卫生—肿瘤]