PNEN与SPTP的临床、病理特点及组织生物标记物检测分析

Clinical and pathological features of PNEN and SPTP and detection of tissue biomarkers

目的对比分析胰腺神经内分泌肿瘤(PNEN)与胰腺实性假乳头状肿瘤(SPTP)的临床及病理特点,并分析E-cad、β-Catenin等生物标记物的鉴别价值。方法收集2014年3月至2019年2月重庆市开州区人民医院病理科存档的42例PNEN和38例SPTP患者的临床及病理资料,并以免疫组化法检测上皮性钙黏附蛋白(E-cad)、β-连接素(β-Catenin)、嗜铬粒素A、突触素、CD10、CD99等表达情况。结果 PNEN患者男、女占比相当,以中老年人居多;SPTP患者以女性及19~29岁年轻人居多;二者性别构成比、年龄有统计学差异(P <0. 05)。临床表现、肿瘤位置和大小无统计学差异(P> 0. 05)。眼观PNEN、SPTP病理表现无显著差异,镜观显示瘤细胞排列、形态、纤维组织增生和玻璃样变性有一定区别。PNEN胞膜或胞浆E-cad阳性表达率达95. 24%,胞核未见β-Catenin阳性表达;而SPTP Ecad阳性表达率仅5. 26%,胞核β-Catenin阳性表达率高达97. 37%;二者E-cad、β-Catenin阳性表达率有统计学差异(P <0. 05)。PNEN、SPTP CD10、嗜铬粒素A、突触素、CD99在胰泡或导管细胞中阳性表达率无统计学差异(P>0. 05),但CD99在PNEN肿瘤细胞中阳性表达于胞膜,而在SPTP中阳性表达于胞质。结论 PNEN与SPTP具有一定的年龄、性别分布特征及病理特点,E-cad、β-Catenin对二者的鉴别具有特异性,均可作为临床诊断依据。

Objective To compare and analyze the clinical and pathological features of pancreatic neuro endocrine neoplasms (PNEN) and solid pseudopapillary neoplasm of the pancreas (SPTP), to analyze differential value of biomarkers such as E-cad and β-Catenin. Methods The clinical and pathological data of 42 PNEN patients and 38 SPTP patients who were filed in the pathology department of the hospital from March 2014 to February 2019 were collected. The expression of E-cad,β-Catenin, chromogranin A, synaptophysin, CD10 and CD99 was detected by immunohistochemistry. Results The proportions of male and female were comparable in PNEN patients. And middle aged and elderly people were the majority. The female and people aged 19 to 29 years old were the majority in SPTP patients. There were significant differences in gender and age between the two ( P <0.05), while there was no significant difference in clinical manifestations, tumor location or size ( P >0.05). There was no significant difference in the pathological findings between PNEN and SPTP by eye view. Microscopically, there were some differences in arrangement of tumor cells, morphology, fibrous tissue proliferation and hyaline degeneration. The positive expression rate of E-cad in PNEN membrane or endochylema was 95.24%. There was no positive expression of β-Catenin in the nucleus. The positive expression rate of SPTP E-cad was only 5.26%, while the positive expression rate of β-Catenin in the nucleus was as high as 97.37%. There were significant differences in positive expression rates between E-cad and β-Catenin ( P <0.05). There was no significant difference in the positive expression rate of CD10, chromogranin A, synaptophysin or CD99 in pancreas acini or duct cells between PNEN and SPTP ( P >0.05). The positive expression of CD99 in PNEN tumor cells was located in cell membrane, while the positive expression of CD99 in SPTP was located in cytoplasm. Conclusion PNEN and SPTP are accompanied with certain age, gender distribution features and pathological features. E-cad and β-Catenin are specific for identification of the two. Both can be applied as basis for clinical diagnosis.