TLE1在单相梭形细胞型及低分化型滑膜肉瘤中的诊断价值  

Diagnostic value of TLE1 in monophasic spindle cell type and poorly differentiated synovial sarcomas

作　　者：吕京澴[1] 王璇[1] 王小桐[1] 沈勤[1] 杨万锐 李锐[1] 周晓军[1] LV Jing-huan WANG Xuan WANG Xiao-tong SHEN Qin YANG Wan-rui LI Rui ZHOU Xiao-jun(Department of Pathology, Jinling Hospital, Nanjing University Medical School, Department of Pathology, Nanjing General Hospital of Nanfing Military Command, Nanjing 21002, China)

机构地区：[1]南京大学医学院附属金陵医院解放军南京总医院病理科,南京210002

出　　处：《诊断病理学杂志》2017年第3期215-219,共5页Chinese Journal of Diagnostic Pathology

基　　金：国家自然科学基金(81372743)

摘　　要：目的观察TLE1蛋白在滑膜肉瘤等恶性梭形细胞肿瘤及低分化肉瘤中的表达,探讨TLE1作为单相梭形细胞型滑膜肉瘤及低分化型滑膜肉瘤标记物的诊断价值。方法采用免疫组化法检测TLE1、bcl-2和CD99在14例单相梭形细胞型及低分化型滑膜肉瘤、5例Ewing肉瘤、4例孤立性纤维性肿瘤、5例恶性外周神经鞘瘤、2例纤维肉瘤、5例隆突性皮肤纤维肉瘤、8例未分化/未分类肉瘤中的表达。其中7例滑膜肉瘤采用FISH方法检测t(X;18)(p11.2;q11.2)染色体易位。结果 TLE1在滑膜肉瘤中阳性率为92.9%,在Ewing肉瘤、孤立性纤维性肿瘤、恶性外周神经鞘瘤、纤维肉瘤、隆突性皮肤纤维肉瘤以及未分化/未分类肉瘤中阳性率分别为20%、25%、40%、0%、20%、37.5%。强阳性率在滑膜肉瘤中为92.9%,未分化/未分类肉瘤中为12.5%,其余几类软组织肉瘤中均为0%。结论 TLE1对于单相梭形细胞型滑膜肉瘤及低分化型滑膜肉瘤具有较高的敏感性和特异性,特别是弥漫强阳性表达特征更有意义,有助于滑膜肉瘤与其他梭形细胞肉瘤及低分化肉瘤的鉴别诊断。Objective To investigate diagnostic value of TLE1 in monophasic spindle cell type and poorly differentiated synovial sarcomas. Methods Immunohistochemistry was used to detect the expression of TLE1,BCL-2 and CD99 protein in 14 cases of monophasic spindle cell type and poorly differentiated synovial sarcomas,5 cases of Ewing sarcomas,4 cases of solitary fibrous tumor,5 cases of malignant peripheral nerve sheath tumor,2 cases of fibrosarcoma,5 cases of dermatofibrosarcoma protuberans,and 8 cases of malignant fibrous histiocytoma respectively. Results The positive expression rate of TLE1 in synovial sarcomas,Ewing sarcomas,solitary fibrous tumor,malignant peripheral nerve sheath tumor,fibrosarcoma,dermatofibrosarcoma protuberans,and malignant fibrous histiocytoma were 92.9%,20%,25%,40%,0%,20% and 37.5% respectively. The high positive rate of TLE1 in synovial sarcomas and malignant fibrous histiocytoma was 92.9% and 12.5%. There was no strong positive expression of TLE1 in other soft tissue sarcoma in our study. Conclusion TLE1 is a sensitive and specific marker for monophasic spindle cell type and poorly differentiated synovial sarcoma,and can be helpful to distinguish synovial sarcoma from other histologic similar sarcoma,especially if moderate or strong staining is observed.

关 键 词：TLE1 单相梭形细胞型滑膜肉瘤 低分化型滑膜肉瘤 免疫组化 

分 类 号：R738.5[医药卫生—肿瘤]