胰腺神经内分泌肿瘤与胰腺实性假乳头状瘤中β-catenin、E-cadherin及CD10的鉴别诊断价值

Role of β-catenin,E-cadherin and CD10 in differential diagnosis between pancreatic neuroendocrine neoplasms and solid-pseudopapillary tumor of the pancreas

目的探讨胰腺神经内分泌肿瘤(pancreatic neuro endocrine neoplasms,PNEN)与胰腺实性假乳头状瘤(solid-pseudopapillarytumor of pancreas,SPTP)的临床病理学特征,并分析联合应用免疫组化标记β-catenin、E-cadherin及CD10的鉴别诊断价值。方法收集2007年3月～2017年2月经明确诊断的53例PNEN和40例SPTP,回顾性分析其临床病理资料,采用免疫组化法观察免疫标志物β-catenin、E-cadherin、CgA、Syn、CD56、CD10、CK在两组肿瘤中的表达。结果 PNEN和SPTP的病理学形态有重叠,β-catenin在PNEN中均为细胞膜、细胞质阳性,而在SPTP中则为细胞核阳性;E-cadherin在PNEN中为细胞膜、细胞质阳性(100%),而在SPTP中均显示细胞膜表达丢失;CD10在SPTP中的阳性率为100%(40/40),在PNEN中不表达。CgA、Syn、CD56、CK在PNEN及SPTP均有不同程度表达。结论β-catenin、E-cadherin及CD10阳性对PNEN和SPTP的鉴别诊断具有特异性,是较有价值的免疫组化标志物。

Purpose To study the pathological characteristics of pancreatic neuroendocrine neoplasms（ PNEN） and solidpseudopapillary tumor of pancreas（SPTP） and to analysis the value of differential diagnosis of specific immunohistochemistry markers including β-catenin, E-cadherin and CD10 in discriminating PNEN and SPTP. Methods 93 cases of pancreatic tumor were collected from from March 2007 to February 2017. 53 cases were diagnosed as PNEN while 40 cases were diagnosed as SPTP by pathologist. The expression of β-catenin, E-cadherin, CgA,Syn, CD56, CD10 and CK in the two groups of tumors were observed by immunohistochemistry. Results PNEN and SPTP had overlapping morphologic features.β-catenin was expressed on the cell member and cytoplasma in PNEN, while in SPTP β-catenin was expressed on nucleus, and there was statistically significant difference. E-cadherin was expressed on the cell member and cytoplasma in PNEN, while in the SPTP the tumor cells showed loss of cell membrane expression. The expression rate of CD 10 in SPTP was 100%（40/40）, while there was no positive expression in PNEN. CgA, Syn, CD56 and CK were expressed in different degrees in PNEN and SPTP. Conclusion The expression of β-catenin, E-cadherin and CD10 is specific to the differential diagnosis of PNEN and SPTP, and they may be the more valuable immunohistochemical marker.