胰腺实体-假乳头状肿瘤32例临床病理分析及TFE3表达的诊断价值  

Diagnostic value of TFE3 expression in solid-pseudopapillary neoplasm of pancreas:a clinicopathological analysis of 32 cases

作　　者：曹钟[1] 魏建国[2] 岑红兵 秦灵芝 廖伟 敖启林[3] CAO Zhong;WEI Jian-guo;CEN Hong-bing;QIN Ling-zhi;LIAO Wei;AO Qi-lin(Department of Pathology,Hubei Huanggang Central Hospital,Huanggang 438000,China;Department of Pathology,Zhejiang Shaoxing the First People’s Hospital,Shaoxing 312000,China;Institute of Patholoy,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Respiratory,Wuhan Fifth Hospital of Hubei Province,Wuhan 430050,China)

机构地区：[1]湖北省黄冈市中心医院病理科,黄冈438000 [2]浙江省绍兴市人民医院病理科,绍兴312000 [3]华中科技大学同济医学院附属同济医院病理研究所/同济医学院病理学系,武汉430030 [4]湖北省武汉市第五医院呼吸内科,武汉430050

出　　处：《临床与实验病理学杂志》2021年第2期162-166,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨胰腺实性-假乳头状肿瘤(solid-pseudopapillary neoplasms, SPN)的临床病理特征及转录因子E3(transcription factor E3, TFE3)表达在诊断中的价值。方法采用免疫组化法检测32例胰腺SPN中TFE3、β-catenin、CD10、CK、vimentin、Syn、CD56、AR、PR的表达,40例胰腺非SPN分别为17例神经内分泌肿瘤(neuroendocrine tumor, NET)、15例导管腺癌(duct adenocarcinoma, DACC)、3例腺泡细胞癌(acinar cell carcinoma, ACC)、3例神经内分泌癌(neuroendocrine carcinoma, NEC)和2例胰母细胞瘤作为对照组,分析TFE3在SPN诊断和鉴别诊断中的应用价值。结果β-catenin、CD10、CK、vimentin、Syn、CD56、AR、PR在胰腺SPN和非SPN中均呈不同程度表达。32例胰腺SPN中TFE3阳性位于肿瘤细胞核,其中28例呈弥漫强阳性,4例呈局部阳性,阳性率为100.0%(32/32);胰腺非SPN中有3例NET、1例NEC和1例ACC呈TFE3阳性,阳性率为12.5%(5/40);两组间差异有显著性(P<0.001)。TFE3对胰腺SPN的敏感性和特异性分别为100.0%和87.5%。TFE3、β-catenin和CD10三者联合的敏感性和特异性分别为93.8%和100.0%,优于TFE3和TFE3联合β-catenin或CD10检测。结论 TFE3在肿瘤细胞核中呈强阳性表达模式是胰腺SPN独特的免疫表型特征;TFE3联合β-catenin、CD10检测具有高敏感性和高特异性,可以作为诊断胰腺SPN的重要诊断标志物。Purpose To investigate the clinicopathological characteristics and diagnostic value of TFE3 expression in solid pseudopapillary neoplasms(SPN)of pancreas.Methods The expression of TFE3,β-catenin,CD10,CK,vimentin,Syn,CD56,AR and PR was detected in 32 cases of SPN of pancreas by immunohistochemistry,and 40 cases of non-SPN tumor of pancreas were used as control group,including 17 cases of neuroendocrine(NET),15 cases of duct adenocarcinoma(DACC),3 cases of acinar cell carcinoma(ACC),3 cases of neuroendocrine carcinoma(NEC)and 2 cases of pancreatoblastoma(PBL).The application value of TFE3 was analyzed in diagnosis and differential diagnosis of SPN.Resultsβ-catenin,CD10,CK,vimentin,Syn,CD56,AR,PR were positively expressed in SPN and control group to some extent.In 32 cases of SPN,the positive signals of TFE3 were located in the tumor cells nucleus,with the positive rate of 100%(32/32),28 cases were diffusely and strongly positive,4 cases were focally positive,whereas 5 cases of control group were TFE3 positive expression,including 3 cases of NET,1 case of NEC and 1 case of ACC,with the positive rate of 12.5%(5/40),and there was significant difference between SPN and control groups(P<0.001).The sensitivity and specificity of TFE3 for SPN were 100.0%and 87.5%respectively.The sensitivity and specificity of combination of TFE3,β-catenin and CD10 were 93.8%and 100.0%,respectively,which was superior to TFE3 alone and TFE3 combined withβ-catenin or CD10.Conclusion The pattern of TFE3 strongly positive expression in tumor cell’s nucleus is a unique immunophenotypic feature of pancreatic SPN;TFE3 combination withβ-catenin and CD10 as an immunohistochemical panel brings about optimal sensitivity and specificity,which can be utilized as diagnostic markers for SPN.

关 键 词：胰腺肿瘤 实性-假乳头状肿瘤 TFE3 免疫组织化学 

分 类 号：R735.9[医药卫生—肿瘤]