CD1a在鞍区病变表达的临床病理学分析

Clinicopathological analysis of CD1a expression in the saddle region

目的探讨CD1a在鞍区病变的表达情况及在病理诊断中的应用意义。方法回顾性分析194例鞍区肿瘤及非肿瘤性病变的CD1a免疫组织化学染色情况。结果 CD1a在15例Rathke's囊肿内的正常垂体细胞、3例增生的腺垂体组织和28例朗格汉斯细胞组织细胞增生症均100%的弥漫性强阳性表达,但在76例垂体腺瘤仅7例灶性阳性。CD1a在6例垂体生殖细胞肿瘤、62例颅咽管瘤、1例颗粒细胞瘤和3例垂体细胞瘤均不表达。结论 CD1a可用于鉴别正常垂体细胞、腺垂体增生和垂体腺瘤,前两者呈弥漫性阳性,后者不表达或呈灶性阳性;由于正常垂体细胞表达CD1a,当有垂体炎时不要误诊为朗格汉斯细胞组织细胞增生症。

Objective To investigate the expression of CD1a in the lesions of the saddle region and its significance in routine pathologi-cal diagnosis.Methods Retrospective analysis was conducted of the immunohistochemical staining of CD1a in 194 cases with saddle region tumors and non-neoplastic lesions.Results CD1a exhibited diffuse strong positivity in all 15 cases of native adenopypophyseal cells,3 cases of hyperplasia of the adenohypophysis,and 28 cases of Langerhans cell histiocytosis（LCH）,but only 7 of 76 cases of pitu-itary adenomas partially stained for CD1a.CD1a was negative in 6 cases of germ cell tumors,62 cases of craniopharyngiomas,1 case of granular cell tumor and and 3 cases of pituicytoma.Conclusions CD1a can contribute to distinguishing native adenopypophyseal cells, hyperplasia of the adenohypophysis from pituitary adenomas.The former showed diffuse strong staining,while the latter did not exhibit immunohistochemical expression or only focal positivity.Because the native adenopypophyseal cells can react to CD1a,we should not misdiagnose hypophysitis as LCH.