胰腺实性假乳头状肿瘤免疫组化特征及其临床意义  

Immunohistochemical features and clinical significances in the solid-pseudopapillary tumor of the pancreas

作　　者：仲伟霞[1] 孙兰萍[2] 李俞慧[2] 孙菊杰[2] 赵炎[2] 宋化著[3] 张玲[1] 

机构地区：[1]山东省医学科学院基础医学研究所免疫室,山东济南250062 [2]山东省肿瘤医院病理科,山东济南250117 [3]菏泽市立医院病理科,山东菏泽274031

出　　处：《中华肿瘤防治杂志》2008年第7期518-521,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：探讨胰腺实性假乳头状肿瘤（solid—pseudopapillary tumor of pancreas，SPT）组织起源、免疫组化和诊断特征以及与性激素受体的关系。方法：对22例SPT手术标本进行常规HE和免疫组化SP法染色。结果：22例患者中男女之比为1：6．3，平均年龄25．4岁。常见的临床表现为腹块、腹痛。19例获得随访资料，其中生存16例，死亡3例，随访时间9～142个月。肿瘤细胞围绕纤维血管复层排列形成假乳头状突起是特征性组织学改变。镜下54．5％（12／22）的肿瘤浸润周围胰腺组织，36．4％（8／22）浸润神经。免疫组化CD10阳性率90．9％（20／22），α1-抗胰蛋白酶86．4％（19／22），波形蛋白72．7％（16／22），突触素45．5％（10／22），嗜铬素A22．7％（5／22），细胞角蛋白9．0％（2／22），胰岛素9．1％（2／22），胰高血糖素4．5％（1／22），S-1004．5％（1／22），PR72．7％（16／22），ER4．5％（1／22），pS2蛋白27．2％（6／22）。癌胚抗原及胃泌素全部阴性。结论：SPT是低度恶性肿瘤，多发生在年轻女性，可能来源于多能干细胞，伴外分泌细胞及内分泌细胞分化，与孕激素受体关系密切。虽然大部分肿瘤呈良性过程，但具有侵袭性行为。手术切除是首选治疗方法。OBJECTIVE ： To study the histogenesis, im munohistochemical and diagnostic features as well as relation with sex hormone receptors in solid-pseudopapillary tumor of the pancreas （SPT）. METHODS： Rouine HE and immunohistochemical （SP） methods were used in 22 cases of SPT. RESULTS： The male： female ratio were 1 ： 6.3. The mean age was 25.4 years, abdominal pain and palpable mass were among main complains. 19 cases were follow-up from 9 to 142 monthes. Sixteen cases were alive. Three cases were died. Histological features were psudopapillary structure with a fibrovascular core. lmmunohistochemically, the tumors were positive for CD10 （90.9%, 20/22）,a1-antitrypsin （86.4%, 19/22）, vimentin （72.7%, 16/22）, synaptophysin （45.5%, 10/22）, chromograninA （22.7%, 5/22）, cytokeratin and insulin （9.1%, 2/22）, glucagons and S-100（4.5%, 1/22）, PR（72.7%, 16/22）, ER（4.5%, 1/22） , pS2（27.2%, 6/22）, but negative for CEA and gastrin. CONCLUSIONS： SPT is a tumor with low malignancy of the pancreas that most frequently affect young females. SPT may be derived from multipotent stem cells with both exocrine celluar and endocrine celluar differentiation. The tumor closely related with progesterone receptors. There is a benign clinical course in the most SPT, but the tumor has a aggressive behavior. Complete removal of SPT is the most perfect treatment.

关 键 词：胰腺肿瘤/病理学 免疫组织化学 诊断 性激素受体 

分 类 号：R735.9[医药卫生—肿瘤]