恶性神经鞘瘤免疫组织化学研究

AN IMMUNOHISTOCHEMICAL STUDY ON MALIGNANT PERIPHERAL NERVE SHEATH TUMORS

近年来研究表明,恶性神经鞘瘤除伴有神经纤维瘤病(von Recklinghausen’s disease,VRD)或伴有神经干累及证据以外,还存在一种无VRD无神经干累及的类型。这一类型的发现,不仅扩大了其病理诊断的范畴,同时也增加了与其它软组织肉瘤如纤维肉瘤、平滑肌肉瘤、滑膜肉瘤或恶性纤维组织细胞瘤等鉴别诊断的难度。目前免疫组织化学技术是对软组织肉瘤进行病理诊断和鉴别诊断的有效方法之一。现将我们一组恶性神经鞘瘤的免疫组织化学研究结果予以报道,并进行讨论。

Immunohistochemical differential diagnosis for 51 melignant peripheral nervesheath tumors(MPNST)from 27soft tissue tumors misdiagnosed as MPNST was studiedby ABC method. MPNSTs showed relatively specific for S-100 protein antibody with a72. 5% positive rates, but only 25 .5% for Leu 7 and 3.9% for MBP. All six leiomyo-sarcoma reacted with Desmin. Six melignant fibrous histiocytoma were positive for α 1-ACT,and 5/6 for α1-AT. Two out of three synovial sarcoma demonstrated reactivity withkeratin. S-100p was also seen in 2/3 liposarcoma. Results indicate that MPNSTs,especially in the absence of von Recklinghausen's disease or nerve-trunk involvement,were confused commonly with the soft tissue sarcomas composed of spindle cells, andthat multiple immunohistochemical markers might be more useful in differential diag-nosis of MPNSTs.