一种有限的免疫组化模式常规实践分型肝腺瘤

译者及来源

译者：大连医院郭坤

来源：美国临床病理学杂志

摘要

β-连环蛋白活化的肝腺瘤合并局灶肝细胞癌的危险性较高。炎症性肝腺瘤的恶性转化倾向也增加，并与全身炎症综合征相关。这两种腺瘤亚型的患者可以从手术切除中获益。我们评估了使用有限的免疫组化标记物组合识别β-连环蛋白活化的肝腺瘤和炎症性肝腺瘤的可能性。46个腺瘤进行了形态学和包括β-连环蛋白、血清淀粉样蛋白A和谷氨酰胺合成酶的免疫组化染色评估。单纯形态学检查给出诊断是25个(54%)炎症性肝腺瘤，3个(7%)β-连环蛋白活化的肝腺瘤，以及18个(39%)其它类型的肝腺瘤。免疫组织化学染色后,15(33%)个腺瘤的形态学亚型诊断得到证实，20(43%)个形态学亚型诊断需要更改，最终的诊断是16(35%)个炎症性肝腺瘤，4(9%)个β-连环蛋白活化的肝腺瘤，7(15%)个β-连环蛋白活化的炎症性肝腺瘤，19(41%)个其它亚型的肝腺瘤。采用免疫组化染色技术可以很容易地识别出炎症性肝腺瘤和β-连环蛋白活化的肝腺瘤。这些发现强调了免疫组化染色对肝腺瘤分类的必要性，因为仅形态学常常不能准确地对肝腺瘤进行分类。

本研究表明仅用有限的免疫标记物组合就可以准确的诊断β-连环蛋白活化的肝腺瘤和炎症性肝腺瘤。

ALimitedImmunohistochemicalPanelCanSubtypeHepatocellularAdenomasforRoutinePractice.

LarsonBK,GuindiM

AmericanJournalofClinicalPathology；Volume,Issue6June:-

Abstract

β-Catenin-activatedhepatocellularadenomashaveanelevatedriskofharboringfociofhepatocellularcarcinoma.Inflammatoryadenomasalsohaveanincreasedpropensityformalignanttransformationandareassociatedwithasystemicinflammatorysyndrome.Patientswiththesetwoadenomasubtypesbenefitfromexcision.Weassessedwhetherβ-catenin-activatedandinflammatoryadenomascouldbeidentifiedusingalimitedimmunohistochemicalpanel.

Forty-sixadenomaswereassessedbymorphologyandβ-catenin,serumamyloidA,andglutaminesynthetaseimmunostains.

Morphologicexaminationproducedamorphologicworkingdiagnosisofinflammatoryadenomain25(54%)of46cases,β-catenin-activatedadenomainthree(7%)of46cases,and18(39%)of46casesofotheradenomas.Afterimmunohistochemicalstaining,themorphologicdiagnosiswasconfirmedin15(33%)of46andchangedin20(43%)of46,forafinaldistributionof16(35%)of46inflammatoryadenomas,four(9%)of46β-catenin-activatedadenomas,seven(15%)of46β-catenin-activatedinflammatoryadenomas,and19(41%)of46otheradenomas.

Inflammatoryandβ-catenin-activatedadenomaswerereadilyidentifiedbyimmunostainingpatterns.Thesefindingsreinforcethenecessityofimmunohistochemistryinclassifyingadenomas,asassessingmorphologyaloneoftenprovidedinaccuratesubclassification.β-Catenin-activatedandinflammatoryadenomascanbeaccuratelydiagnosedusingonlyalimitedpanelofwidelyavailableimmunostains.

一种有限的免疫组化模式常规实践分型肝腺瘤

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