隆突性皮肤纤维肉瘤中载脂蛋白D的表达及意义

Expression of apolipoprotein D and its diagnostic value in dermatofibrosarcoma protuberans:A study of 25 cases

目的研究载脂蛋白D在隆突性皮肤纤维肉瘤中的表达特点及诊断价值,并探讨组织芯片技术的可行性。方法制备包括25例隆突性皮肤纤维肉瘤、30例皮肤纤维组织细胞瘤、10例恶性纤维组织细胞瘤、4例纤维肉瘤、10例神经纤维瘤、5例结节性筋膜炎在内的组织芯片,用免疫组化SP法及原位杂交分别检测载脂蛋白D的蛋白及 mRNA表达水平。结果免疫组化载脂蛋白D在隆突性皮肤纤维肉瘤中阳性表达率为92.0%(23/25),在皮肤纤维组织细胞瘤中的阳性表达率为6.7%(2/30),二者之间的表达差异有统计学意义(χ2=36.79,P<0.05)。原位杂交在22例隆突性皮肤纤维肉瘤有20例检测到载脂蛋白D mRNA表达,阳性表达率为90.9%,在皮肤纤维组织细胞瘤中这阳性表达率则为7.7%(2/26),二者之间表达差异亦有统计学意义(χ2=33.24,P<0.05)。结论载脂蛋白D可作为临床鉴别诊断隆突性皮肤纤维肉瘤与皮肤纤维组织细胞瘤的新型标记物;应用组织芯片技术可对组织样本进行高通量的有效检测。

Purpose To investigate the expression pattern and the potential diagnostic value of apolipoprotein D in dermatofibrosarcoma protuberans and to evaluate the applicability of tissue microarray in pathological studies. Methods A tissue microarray was constructed, which contained 120 dots of formalin-fixed, paraffin-embedded tissue samples, including 25 cases of dermatofibrosarcoma protuberans, 30 cases of cutaneous fibrous histiocytoma, 10 cases of malignant fibrous histiocytoma, 4 cases of fibrosarcoma, 10 cases of neurofibroma, 5 cases of nodular fasciitis and 5 cases of normal adult testis used as controls. Immunohistochemical markers, including apolipoprotein D and CD34, were used on the tissue microarray sections by the SP immunohistochemical staining method. In situ hybridization （ISH） using an apolipoprotein D oligonucleotide probe was also performed on the tissue microarray sections. Results Immunohistochemically, positive staining of apolipoprotein D was seen in 23 of 25 （92.0%） cases of dermatofibrosarcoma protuberans and 2 of 30 （6. 7% ） cases of cutaneous fibrous histiocytoma, whereas by ISH positive staining of apolipoprotein D was seen in 20 of 22 （90. 9% ） cases of dermatofibrosarcoma protuberans and 2 of 26 （7.7%） cases of cutaneous fibrous histiocytoma. The expression pattern of apolipoprotein D between dermatofibrosarcoma protuberans and cutaneous fibrous histiocytoma had statistical difference （ P 〈 0.05 ）. Conclusions The tissue microarray technique provides a reliable method to investigate apolipoprotein D expression on a large scale. Apolipoprotein D may be a useful immunohistochemical marker in the differential diagnosis between dermatofibrosarcoma protuberans and cutaneous fibrous histiocytoma.