显微镜下脊索瘤病理分型表现及相关上皮性、间叶性标记物表达研究

Research about pathological classification of chordoma under microscope and expressions of related epithelial and mesenchymal markers

目的探讨显微镜下脊索瘤病理分型表现及相关上皮性、间叶性标记物表达情况。方法选择60例脊索瘤患者进行回顾性总结,镜下观察手术切除的组织样本病理分型特征,并利用免疫组化染色法对其相关上皮性、间叶性标记物做免疫学标记,统计其阳性表达率。结果肿瘤多呈膨胀性圆形或球状生长,病理特征明显,镜下主要以空泡样或液滴状细胞为主,且以分叶状排列。60例脊索瘤免疫组化染色阳性表达结果:上皮膜抗原(EMA)、癌胚抗原(CEA)、细胞角蛋白(CK)阳性率分别为93.33%、1.67%、100%。S-100蛋白(S-100)、波形蛋白(VIM)阳性率分别为90.00%、100%。结论脊索瘤多发于脊柱两端的迷行脊索部位,临床病理特征明显,但与黏液性癌、软骨肉瘤等其他肿瘤疾病形态相似,临床诊断应结合免疫组化CK、S-100、VIM等标记检查,辅助提高脊索瘤确诊率,避免误诊。

Objective To research the microscopic pathological classification of chordoma under microscope and expressions of related epithelial and mesenchymal markers.Methods Totally 60 cases with chordoma were retrospectively summarized.Pathological typing characteristics of resected tissue samples were observed under microscope,immunohistochemical staining was used to label the related epithelial and mesenchymal markers,and the positive expression was counted.Results The tumors showed expansive circular or spherical growth with the obvious pathological features,mainly performed the vacuolar or droplet shaped cells,and lobulated arrangement.The immunohistochemistry results showed that the positive rates of epithelial membrane antigen(EMA),Carcino embryonic antigen(CEA)and cytokeratin(CK)were93.33%,1.67%and 100%,respectively.S-100 protein(S-100)and vimentin(VIM)were 90.00%and 100%.Conclusion Chordoma mainly occur in the labyrinthine chorda at both ends of the spine with obvious clinicopathological features.But its morphology is similar to the mucinous carcinoma and chondrosarcoma.The clinical diagnosis combined with immunohistochemistry of CK,S-100,and VIM mark can help to the diagnosis of chordoma.