S-100蛋白、CD1a、CD83及Ki-67在口腔朗格汉斯细胞组织细胞增生症中的表达及意义

The expression of S-100 protein,CD1a,CD83 and Ki-67 in oral Langerhans cell histiocytosis

目的对口腔朗格汉斯细胞组织细胞增生症(LCH)病例进行临床病理回顾性研究及多种免疫表型检测,观察该类疾病的临床病理特征,并对其诊断、鉴别诊断等进行探讨。方法选择原病理诊断为LCH的29例患者为研究对象,分析其临床病理特点;采用链亲和素-生物素-过氧化物酶(SP)法和Elivison二步法检测S-100蛋白、CD1a、CD83及Ki-67在LCH中的表达情况,观察其免疫组织化学结果并进行统计学分析。结果 29例LCH中有5例S-100蛋白、CD1a检测为阴性,排除LCH诊断。在24例LCH中,男性15例,女性9例;患者中位年龄为7.50岁;14例发生于下颌骨,5例发生于上颌骨,5例发生于上下颌骨;按照Bartnick分类,Ⅰ类9例,Ⅱ类13例,Ⅲ类2例;S-100蛋白、CD1a均为阳性表达;颌面部单发骨病损与侵及软组织的颌面部病损相比,Ki-67阳性率较低,而CD83阳性率较高。结论 S-100蛋白、CD1a对于LCH的诊断具有重要意义。颌面部单发的骨LCH可能具有较低的增殖活性,并处于较高的成熟状态;侵及软组织的颌面部LCH可能具有较高的增殖活性,并处于较低的成熟状态。

Objective To study clinicopathological features, diagnosis, differential diagnosis of oral Langerhans cell histiocytosis （LCH）, retrospective clinicopathologic study was carried on and a variety of immune phenotype were de -tected. Methods The clinicopathological features of 29 cases of oral LCH were analyzed. The immunohistochemical staining of S-100 protein, CDla, CD83 and Ki-67 were used in above cases by immunohistochemical streptavidin- biotin peroxidase （SP） and Elivison two-step method. Statistical analysis was adopted for the results. Results Of the 29 cases of LCH, the expression of S-100 protein and CDla were positive in 24 cases and negative in 5 cases, so 5 cases were excluded from the diagnosis of LCH. Among 24 cases of LCH, 15 patients were male and 9 were female. The median age was 7.50 years. 14 lesions were in the mandible, 5 were in the maxilla and 5 involved the mandible and maxilla. 9 cases were in stage Ⅰ , 13 in stage Ⅱ and 2 in stage Ⅲ, according to Bartnick classification. Immuno- histochemistry showed all 24 cases staining for S-100 protein and CDla were positive. Comparing with maxillofacial lesions involved soft tissue, Ki-67 positive rate was lower and CD83 positive rate was higher in maxillofacial single bone lesion. Conclusion The immunohistochemical staining of S-100 protein and CDla are important for the diagnosis of LCH. Maxillofacial bone single LCH might have lower proliferative activity and a higher state of maturity. Maxillofacial LCH involved soft tissue might have a higher proliferative activity and a lower state of maturity.