SPARC在上皮样间皮瘤中的表达及病理诊断应用  

Expression of SPARC and its application of pathological diagnosis in epithelioid mesothelioma

作　　者：崔镓钰 高鑫鑫 马敬 盛智梅 潘梓欣 张宝刚 CUI Jia-yu;GAO Xin-xin;MA Jing;SHENG Zhi-mei;PAN Zi-xin;ZHANG Bao-gang(Affiliated Hospital of Shandong Second Medical University/School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,China;Department of Pathology,Shandong Second Medical University,Weifang 261053,China)

机构地区：[1]山东第二医科大学附属医院,山东第二医科大学临床医学院,山东潍坊261053 [2]山东第二医科大学基础医学院临床病理系,山东潍坊261053

出　　处：《诊断病理学杂志》2025年第2期152-156,共5页Chinese Journal of Diagnostic Pathology

基　　金：国家自然科学基金面上项目(No 82373124,81872163,81672631)。

摘　　要：目的探究富含半胱氨酸的酸性分泌蛋白(SPARC)在实体型上皮样恶性间皮瘤(MM)、低分化肺鳞状细胞癌及实体型肺腺癌中免疫表型表达情况及其在病理诊断和鉴别诊断中的应用价值。方法回顾性分析4例实体型上皮样MM与7例低分化肺鳞状细胞癌及14例实体型肺腺癌的临床病理学及免疫表型特征,并复习相关文献。结果SPARC在实体型上皮样MM与低分化肺鳞状细胞癌及实体型肺腺癌中表达差异有显著性(P<0.05),SPARC在区分实体型上皮样间皮瘤与实体型肺腺癌和低分化肺鳞状细胞癌方面表现出高敏感性(100%)和较高的特异性(90%)。结论实体型上皮样MM为罕见肿瘤,恶性程度高,预后较差,临床表现和组织学形态易与低分化肺鳞状细胞癌及实体型肺腺癌混淆,术前及冷冻病理诊断误诊率高,新型间皮标志物SPARC有助于其鉴别诊断。Objective To investigate the immunophenotypic expression of secreted protein acidic and rich in cysteine(SPARC)in solid-type epithelioid malignant mesothelioma(MM),poorly differentiated lung squamous cell carcinoma,and solid-type lung adenocarcinoma,and to evaluate its value in pathological diagnosis and differential diagnosis.Methods A retrospective analysis of the clinicopathological and immunophenotypic characteristics of 4 cases of solid-type epithelioid MM,7 cases of poorly differentiated lung squamous cell carcinoma,and 14 cases of solid-type lung adenocarcinoma was conducted,along with a review of the relevant literature.Results There was a significant difference in SPARC expression among solid-type epithelioid MM,poorly differentiated lung squamous cell carcinoma,and solid-type lung adenocarcinoma(P<0.05).SPARC demonstrated high sensitivity(100%)and relatively high specificity(90%)in distinguishing solid-type epithelioid mesothelioma from solid-type lung adenocarcinoma and poorly differentiated lung squamous cell carcinoma.Conclusion Solid-type epithelioid MM is a rare tumor with high malignancy and poor prognosis.Its clinical presentation and histological morphology can easily be confused with poorly differentiated lung squamous cell carcinoma and solid-type lung adenocarcinoma,leading to a high rate of misdiagnosis in preoperative and frozen pathological diagnoses.The novel mesothelial marker SPARC aids in the differential diagnosis of these conditions.

关 键 词：SPARC 上皮样间皮瘤 实体型肺腺癌 低分化肺鳞状细胞癌 鉴别诊断 

分 类 号：R73[医药卫生—肿瘤]