原发性十二指肠梭形细胞鳞癌的组织形态学及蛋白表达的研究

Histomorphology and protein expression in primary duodenum spindle cell squamous carcinoma

目的探讨十二指肠梭形细胞鳞癌的组织形态学及蛋白表达的特点,明确其组织学来源,以提高对该疾病的认识和诊断水平。方法运用HE染色法了解十二指肠梭形细胞鳞癌的组织形态学特点;通过免疫组织化学染色法进一步了解其蛋白表达特点。结果 HE染色显示黏膜层、黏膜下层及肌层见大小不等异型性明显的梭形肿瘤细胞,并见部分不典型细胞间桥和角化珠形成。免疫组织化学染色结果显示梭形肿瘤细胞区域:⑴胞浆着色:CK5/6(+++)、CEA(+++)、CK8/18(++)、Syn(+)、NSE(+)、CgA(+)及S-100蛋白(+);⑵胞核着色:Ki-67(+++);⑶CD34和CD117显示阴性。结论十二指肠鳞状细胞癌起源于十二指肠黏膜基底层多潜能干细胞。

Objective To explore the histomorphology and protein expression characteristics of the primary duodenum spindle cell squamous carcinoma, and determine its histological origin, and provide comprehensive under-standing in the awareness and diagnosis of this disease. Methods HE staining was used to understand the histomor-phology features of the primary duodenum spindle cell squamous carcinoma, and immunohistochemistry staining was applied to detect the protein expression. Results The HE staining showed pleomorphism fusiform tumor cells in the mucosa, submucosa, and muscular, with a few atypical intercellularbridge and keratin pearl. And the immunohisto-chemical staining revealed fusiform tumor cell area as follows：（1） staining in cytoplasm：CK5/6（3＋）, CEA（3＋）, CK8/18 （2＋）, Syn （＋）, NSE（＋）, CgA（＋） and S-100 protein（＋）;（2） staining in nuclei：Ki-67 （3＋）;（3） negative in CD34 and CD117. Conclusion The primary duodenum spindle cell squamous carcinoma arised from the multipotent stem cell in the basal layer of the mucosa duodenum.