醛固酮合酶免疫组化染色在原发性醛固酮增多症病理诊断中应用  

Application of CYP11B2 immunohistochemistry in the histopathological diagnosis of primary aldosteronism

作　　者：杨溢[1] 肖明 宋颖[1] 李佳渝 程庆丰[1] 杨淑敏[1] 胡金波[1] 杜志鹏[1] 李启富[1] Yang Yi;Xiao Ming;Song Ying;Li Jiayu;Cheng Qingfeng;Yang Shumin;Hu Jinbo;Du Zhipeng;LI Qifu(Department of Endocrinology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Pathology,College of Basic Medicine,Chongqing Medical University,Chongqing 400016,China;Chongqing Colleges and Universities Key Laboratory of Major Metabolic Disease and Translational Medicine)

机构地区：[1]重庆医科大学附属第一医院内分泌科,400016 [2]重庆医科大学基础医学院病理学教研室,400016 [3]重庆医科大学附属第一医院,重大代谢性疾病转化医学重庆市高校重点实验室,400016

出　　处：《中华内分泌代谢杂志》2019年第11期939-944,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81370954,81670785);重庆市基础科学与前沿技术研究专项(cstc2015jcyjBX0096);重庆市社会事业与民生保障科技创新专项子课题(cstc2016shms-ztzx1003);重庆市科卫联合医学科研项目(青年项目2018QNXM001)。

摘　　要：目的 在中国人群中,探讨醛固酮合酶CYP11B2免疫组化染色在原发性醛固酮增多症(PA)患者病理诊断中的价值.方法 回顾性纳入96例行单侧肾上腺切除的PA患者,并纳入15例无功能皮质腺瘤患者和15例皮质醇瘤患者作为对照.对上述术后组织标本行CYP11B2免疫组化染色,并对其CYP11B2表达进行半定量评分,计算CYP11B2表达的阳性率;根据组织病理学特征及CYP11B2染色,对上述PA患者的术后标本进行病理分型.结果 PA患者术后标本中CYP11B2的阳性率为91.7%(88/96),而对照组中CYP11B2染色阳性率为6.7%(2/30),两组差异具有统计学意义(P<0.001).亚组分析显示醛固酮瘤和单侧肾上腺皮质增生的CYP11B2免疫组化染色阳性率分别为91.8%(78/85例)和90.9%(10/11例).根据组织学特征及CYP11B2染色,将上述PA患者的术后标本进一步分为醛固酮瘤(85例)、单侧弥漫性增生(7例)、单侧结节性增生(1例)、单侧多结节性增生(1例)及多发醛固酮分泌的细胞簇(APCC,2例).结论 CYP11B2免疫组化染色可作为原醛症病理诊断的一种有用工具.Objective To evaluate the value of CYP11B2 immunohistochemistry in the histopathological diagnosis of primary aldosteronism(PA)among Chinese population.Methods Ninety-six cases of unilateral PA patients were retrospectively enrolled,and with 15 cases of non-hyperfunctioning adenoma,and 15 cases of cortisol producing adenoma as control.CYP11B2 immunohistochemistry was performed in the tumor sections of these patients and was analysed by semi-quantified method.The positive rate of CYP11B2 in tumor specimen of all cases enrolled was calculated and PA patients were subtypely classified based on their histopathological features and CYP11B2 expressions.Results The immune-positive rate of CYP11B2 in the PA group was 91.7%(88/96),with the control group being 6.7%(2/30,P<0.001).Subgroup analysis revealed that the immune-positive rate of CYP11B2 in the aldosterone producing adenoma group and unilateral hyperplasia group were 91.8%(78/85)and 90.9%(10/11),respectively.Based upon histopathological feature and CYP11B2 immunohistochemistry,PA patients were further subtypely classified as aldosterone producing adenoma(85/96),unilateral diffuse adrenocortical hyperplasia(7/96),unilateral mono-adrenocortical micronodules(1/96),unilateral multiple adrenocortical micronodules(1/96),and unilateral multiple aldosterone-producing cell clusters(multiple APCCs,2/96).Conclusion CYP11B2 immunohistochemistry may serve as an useful tool for the histopathological diagnosis of PA.

关 键 词：原发性醛固酮增多症 免疫组织化学 病理诊断 

分 类 号：R73[医药卫生—肿瘤]