甲状腺转录因子1和表面活性蛋白在肺硬化性血管瘤中表达的意义

Biologic significance of thyroid transcription factor-1 and surfactant protein expression in pulmonary sclerosing hemangioma

目的 探讨甲状腺转录因子 1(TTF 1)和表面活性蛋白A、B(SP A ,SP B)在肺硬化性血管瘤 (PSH)中表达的生物学意义。方法 用免疫组织化学的方法 ,检测 4 2例经外科手术切除、病理诊断的PSH标本中TTF 1、SP A、SP B和上皮膜抗原 (EMA)、波形蛋白 (vimentin)、广谱角蛋白(pancytokeratin)、角蛋白 7(CK7)、CK5 / 6、钙结合蛋白 (calretinin)、S 10 0蛋白、神经元特异性烯醇化酶(NSE)、突触素 (Syn)、嗜铬素A(CgA)、CD3 4 、Ⅷ因子相关抗原 (F Ⅷ )、平滑肌肌动蛋白 (SMA)的表达状况 ,其中 10例进行透射电镜观察。结果 病理组织学上肿瘤主要由多角形细胞和立方细胞组成 ;免疫组织化学显示 95 % (4 0 / 4 2 )患者立方细胞和多角形细胞共同表达TTF 1、88% (37/ 4 2 )表达EMA、5 7% (2 4 / 4 2 )表达vimentin ,93% (39/ 4 2 )患者立方细胞表达SP A、81% (34/ 4 2 )表达SP B、10 0 %(4 2 / 4 2 )表达 pancytokeratin ;2 4 % (10 / 4 2 )患者多角形细胞散在表达Syn、14 % (6 / 4 2 )表达NSE、12 %(5 / 4 2 )表达S 10 0和 12 % (5 / 4 2 )表达CgA ;TTF 1和EMA在这两种细胞之间的表达状况差异无显著性 (χ2 分别为 0 0 0 0和 3 4 0 3,P >0 0 5 ) ,vimentin在这两种细胞之间的表达差异有显著性 (χ2 =10 118,P

Objective To investigate the biologic significance of thyroid transcription factor-1(TTF-1) and surfactant protein A(SP-A) and SP-B expression in pulmonary sclerosing hemangioma (PSH). Methods TTF-1, SP-A, SP-B, epithelial membrane antigen(EMA), pancytokeratin(AE 1/AE 3), vimentin, CK7,CK5/6,calretinin,S-100,neuron specific enolase(NSE),synaptophysin(Syn),chromogranin A(CgA),CD 34,Factor Ⅷ and smooth muscle actin(SMA)in 42 patients with PSH were examined with immunohistochemistry, while samples from 10 patients were also observed by electron microscope. Results Histopathologically, PSH mainly consisted of both surface lining cuboidal cells and pale polygonal cells. Both of them were stained with TTF-1, EMA and vimentin, whereas SP-A, SP-B, pancytokeratin and CK7 were only positive in surface lining cuboidal cells. Syn,NSE, S-100 and CgA showed scattered positivity in these cells. There was no significant difference in the expressions of TTF-1 and EMA between these two cell types ( P>0.05), whereas the difference was significant in the expression of vimentin ( P<0.01). The ultrastructural features cannot differentiate these two cells by electron microscope. Conclusions It is suggested that PSH is derived from primitive respiratory epithelium, and both surface lining cuboidal cells and pale polygonal cells were entity cells of the tumor. Examination of different immunohistochemical markers including TTF-1, SP-A, SP-B, pancytokeratin, EMA and vimentin is helpful in the diagnosis and differential diagnosis of PSH.