儿童横纹肌肉瘤免疫组织化学诊断评估  

The immunohistochemical diagnosis of childhood rhabdomyosarcoma

作　　者：信明军[1] 施诚仁[1] 张忠德[1] 李敏[1] 陈方[1] 潘伟华[1] 

机构地区：[1]上海第二医科大学附属新华医院小儿外科,200092

出　　处：《中华小儿外科杂志》2001年第3期141-143,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　对目前常用的 6种免疫组织化学标志物 波纹蛋白 (vimentin ,Vim)、结蛋白(desmin、Des)、肌红蛋白 (myoglobin ,MG)、肌球蛋白 (myosin ,MS)、平滑肌肌动蛋白 (smooth muscleactin ,SMA)、肌节肌动蛋白 (sarcomericactin ,Sr A)在横纹肌肉瘤 (RMS)诊断中的应用价值进行探讨。方法　 2 4例RMS及其他多种儿科肿瘤标本均来自手术切除组织 ,经 10 %中性甲醛固定 ,石蜡包埋。切片采用LSAB三步法进行免疫组织化学染色 ,另外用高温组织抗原修复法提高Des、MS、Sr A3种标志物的阳性率和阳性强度。结果　 6种标志物在RMS中的阳性率由高到低依次为Vim、MG、MS、Des、Sr A ;特异度由高到低为Sr A、Des、SMA、MG、Vim(MS资料暂缺 ) ;实验有效率由高到低是Des、MG、Sr A、SMA、Vim。结论　Vim和MG对RMS的灵敏度最高 ,但二者的特异性均较差 ;而特异性最佳的Sr A和Des在RMS中表达的阳性率却不高。因此 ,对分化较差的RMS必须联合采用多种抗体进行标记 ,结合对实验有效率的分析 ,建议优先联合使用Des、MG和Sr A。Objective To evaluate the sensitivity and specificity of regularly used immunohistochemical markers, including Vimentin (Vim), Desmin(Des), Myoglobin (MG), Myosin (MS), Smooth muscle actin(SMA) and Sarcomeric actin (Sr A), in the diagnosis of rhabdomyosarcoma (RMS).Methods After resection, 24 RMSs and other childhood tumor specimens were fixed in 10% neutral buffered formalin and embeded in paraffin. The immunohistochemical staining was performed by LSAB procedure. Heat induced epitope retrieval of Des,MS,Sr A was conducted in order to enhence positive rate and positive strength. Results Vim, MG, MS, Des, Sr A, SMA were arranged in the order of sensitivity from higher to lower, As to specificity, Sr A, Des, SMA, MG, Vim standed in a sequence from higher to lower (the data of MS not available); Des,MG, Sr A had higher experimental efficiency, followed by SMA,Vim in a succession.Conclusions Vim and MG were of the higher sensitivity but lower specificity. Sr A and Des showed hight specificity but lower sensitivity. So the combination of multiple antibody reactions should be considered to improve the diagnostic ability in poorly differentiated RMS. It is recommended that the combination of Des, MG and Sr A be used to achieve definite diagnose of the majority of RMS.

关 键 词：横纹肌肉瘤 诊断 免疫组织化学 儿童 

分 类 号：R738.7[医药卫生—肿瘤]