颅内肿瘤细胞异质性的免疫组织化学研究

Immunohistochemical Study of Intratumoral Heterogeneity of 55 Patients with Intracranial Nooplasms

应用抗胶质纤维酸性蛋白（ＧＦＡＰ）、抗牛Ｓ－１００蛋白（Ｓ－１００）、抗波形蛋白（Ｖｉｍｅｎｔｉｎ）、抗神经特异性烯醇化酶（ＮＳＥ）、抗癌胚抗原（ＣＥＡ）及抗人角蛋白（Ｋｅｒａｔｉｎ）免疫血清，采用ＡＢＣ法（卵白素－生物素－过氧化物酶复合物法），分别对５５例颅内肿瘤（原发神经组织肿瘤４９例，转移癌６例）进行检测，并进行瘤细胞异质性的研究。结果显示，在同一时瘤组织内免疫染色阳性细胞在质与量的分布上极不均匀；瘤细胞免疫染色反应与肿用的组织学分红或／及细胞生长率（核分裂计数）之间未见明显相关。研究提示：（１）抗元ＧＦＡＰ、Ｓ－１００、Ｖｉｍｅｎｔｉｎ、ＮＳＥ、ＣＥＡ及Ｋｅｒａｔｉｎ血清的免疫染色在颅内肿瘤的诊断与鉴别诊断上极有价值；（２）免疫在型异质性所显示的肿瘤细胞亚群与病理组织学分级并不完全相同，要获得肿瘤的正确诊断与分类，从多处瘤组织取材及多种抗体免疫染色是必要的；（３）颅内肿瘤细胞免疫组织化学异质性的生物学意义有待阐明。

The immunohistologic heterogeneity of the intratumoral cells in55 cases of intracranial neo-plasms,including 49 primary tumors originated from central nervous system and 6 metastatic carcino-mas from extracranial organs,were detected with polyclonal or monoclonal antibodies to GPAP,S- 100,vimentin,NSE,CEA,and keratin by immunoporoxidase techniques. The results showed thatthe distributions of the immunostaining positive cells both in quantity and quality revealed quite unevenwithin tumor tissues. Moreover,no satisfactory correlation between the positive immunoreactivity ofthe tumor cells and the histologic grades or/and the tumor growth rate(assessed by mitosis)could beseen by this study,Our work suggest that:(1)anti-GPAP,anti0S-100,anti-vimentin,anti-NSE,an-ti-CEA and anti-keratin immunostaining for the diagnosis and differential diagnosis of the intracranialneoplasms are valuable and very useful;(2)the immunophenotypic heterogeneity within tumor re-vealed different neoplastic cell subpopulation which seems indepen dent from the histopatholoic pat-terns;(3)the biological significance of the unmunohistologic heterogeneity of intratumoral cells re-mains to be clarifid.