角蛋白系列抗体在骨性纤维结构不良诊断中的意义

Diagnostic significance of a series of Keratin antibodies in osteofibrous dysplasia

目的探讨免疫组化角蛋白系列抗体在骨性纤维结构不良(osteofibrous dysplasia,OFD)诊断及鉴别诊断中的意义。方法收集38例OFD及30例纤维结构不良(fibrous dysplasia,FD)、3例OFD样釉质瘤,通过光镜观察及免疫组化标记角蛋白系列抗体(CKpan、CK5/6、CKHMW、CK19、CK7、CK20、CK8、CK18)进行对比分析。结果 38例OFD中均可见散在角蛋白阳性的细胞,CKpan、CK5/6、CKHMW和CK19阳性率分别为100%、100%、100%、65.8%,且高分子量角蛋白表达较强,低分子量角蛋白CK7、CK20、CK8、CK18均阴性。30例FD中角蛋白抗体均阴性。3例OFD样釉质瘤中均可见角蛋白巢状阳性细胞。结论免疫组化出现散在角蛋白抗体阳性细胞可用于鉴别OFD与FD,角蛋白阳性细胞呈巢状时应诊断为OFD样釉质瘤。高分子量角蛋白可更好的显示OFD中的阳性细胞。

Purpose To investigate the diagnostic and differential diagnostic significance of the series of Keratin immunohistochemical antibodies in osteofibrous dysplasia. Methods The clinicopathologic data were collected in 38 cases of osteofibrous dysplasia,30 fibrous dysplasia and 3 osteofibrous dysplasia-like adamantoma. The immunohistochemical staining of Keratin antibodies including CKpan,CK5 /6,CKHMW,CK19,CK7,CK20,CK8 and CK18 was performed in each case and studied by light microscopy. Results Scattered Keratin positive cells were detected in all 38 cases of osteofibrous dysplasia,the positive rates were 100%（ CKpan）,100%（ CK5 /6）,100%（ CKHMW）,and 65. 8%（ CK19）,and the expression of high molecular weight Keratin antibodies were stronger than CKpan,low molecular weight Keratin antibodies were negative in osteofibrous dysplasia. Keratin antibodies were negative in all fibrous dysplasia. Nested Keratin positive cells were detected in all 3 cases of osteofibrous dysplasia-like adamantoma. Conclusion Positive scattered Keratin positive cells can be a differential diagnostic character between osteofibrous dysplasia and fibrous dysplasia.The diagnosis of osteofibrous dysplasia-like adamantoma should be made when nested Keratin positive cells are detected. High molecular weight Keratin antibodies are better in the detection of Keratin positive cells.