嗜铬素A和突触素在肾上腺肿瘤中的表达及其临床意义

The expression and significance of chromogranin A and synaptophysin in adrenal gland tumors

目的探讨嗜铬素A(CgA)和突触素(Syn)在各型肾上腺肿瘤中的表达及其临床意义。方法对69例肾上腺肿瘤和4例正常肾上腺组织运用免疫组化方法进行组织染色,研究CgA和Syn的表达,并采用χ2检验进行统计学分析。结果在正常肾上腺组织,CgA和Syn主要表达于髓质。CgA在全部25例嗜铬细胞瘤中均呈阳性表达,而在肾上腺皮质肿瘤中极少表达;Syn在肾上腺皮质腺瘤、皮质癌、嗜铬细胞瘤及肾上腺转移癌的阳性表达率分别为96.4%(27/28)、87.5%(7/8)、96.0%(24/25)和75.0%(6/8)。结论CgA在肾上腺皮质与髓质肿瘤间、嗜铬细胞瘤与恶性嗜铬细胞瘤间的表达率差异有统计学意义。CgA、Syn可作为标志物对各型肾上腺肿瘤进行鉴别诊断。

Objective To investigate the expression of chromogranin A （CgA） and synaptophysin （Syn） for differential diagnosis of different kinds of adrenal gland tumors. Methods The samples of 69 adrenal gland tumors and 4 normal adrenal glands were immunohistochemically analyzed for the expression of chromogranin A and synaptophysin. The statistical analysis of the data was performed using chi-square test. Results In the normal adrenal gland, CgA and Syn was exclusively detected in the medulla. CgA was detected in all pheochromocytomas 25/25（100%）, and gave less or no expression in adrenecortical tumors. Syn was detected in adrenecortical adenomas 27/28 （96.4 % ）, adrenecortical carcinoma 7/8 （ 87.5 % ）, pheochromocytoma 24/25 （ 96.0 % ） and adrenal metastatic carcinoma 6/8 （75.0%）, respectively. Conclusion There is statistically significant difference of CgA expression between adrenalcortical and adrenal medullary tumors, and also between benign and malignant pheechromecytomas. CgA and Syn are immunohistechemically reliable markers in the differential diagnosis of various kinds of adrenal gland tumors.