骨转移性腺癌的免疫组织化学研究

Immunohistochemical study of skeletal metastatic adenocarcinoma

目的 观察来源不同的骨转移性腺癌的病理形态和免疫组化的表达情况 ,以探讨来源不明的骨转移性腺癌的原发部位。方法 对 137例原发部位明确的骨转移性腺癌进行了病理形态学观察 ,同时应用S P免疫组化方法分别进行CK7、CK2 0、ER、PR、PSA和vimentin检测。结果 根据组织形态可以确定某些骨转移性腺癌的原发部位。CK7和CK2 0在来源不同的肿瘤中表达有明显差别 :CK7(+) /CK2 0 (- )的肿瘤有骨转移性肺癌、乳腺癌、子宫内膜腺癌及卵巢癌 ;明显CK7(+) /CK2 0 (+)的肿瘤有骨转移性胰腺癌和胆囊腺癌 ;骨转移性大肠癌、胃癌显示CK7(- ) /CK2 0 (+) ;而骨转移性前列腺癌不表达CK7和CK2 0。女性患者中 ,骨转移性乳腺癌、子宫内膜腺癌PR、ER表达率高 ,而其他骨转移性腺癌不表达PR和ER。 8例骨转移性前列腺癌均表达PSA。结论 CK7和CK2 0在鉴别骨转移性腺癌中具有重要意义 。

Objective To study the distinctive histopathological and immunohistochemical differences between metastatic adenocarcinoma of bone from different site. Methods The morphologic feature of 137 cases skeletal metastatic adenocarcinomas from our department were reviewed. Immunostainings for CK7, CK20, ER, PR, PSA, Vimentin were performed with SP staining methods. Result The primary sites of some metastatic adenocarcinomas of bone can be identified according their histopathologic fetures. CK7andCK20 expression has differences in different adenocarcinomas: CK7+/CK20- immunophenotype was seen in the majority of metastatic adenocarcinomas arising from lung, breast, endometrium,ovary. The subset of tumors strongly expression both CK7 and CK20 included pancreatic adenocarcinomas and adenocarcinoma of gallbladder.The tumors negyive for both CK7 and CK20 were largely restricted to hepatocellular, prostate, and renal cell carcinomas. Wereas CK7-/CK20+ was highly characteristic of adenocarcinomas from colorectal and gastric origin. Conclusions CK7 and CK20 have been proved to be useful antibodies in distinguising metastatic adenocarcinomas of bone. Combined use of a panel of antibodies can give more significant result.