Microtubule-associated protein-2 immunoreactivity:: a useful tool in the differential diagnosis of low-grade neuroepithelial tumors
Microtubule-associated protein-2 immunoreactivity:: a useful tool in the differential diagnosis of low-grade neuroepithelial tumors
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DOI：
10.1007/s00401-004-0873-8
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发表时间：
2004-08-01
影响因子：
12.7
通讯作者：
Wiestler, OD
中科院分区：
文献类型：
--
作者：
Blümcke, I;Müller, S;Wiestler, OD
复杂多变的形态表型对神经上皮肿瘤的组织病理学分类提出了重大挑战。这尤其适用于低级别神经胶质瘤和神经胶质瘤。最近，我们和其他人已经确定微管相关蛋白-2 （MAP2）是在大多数胶质肿瘤中表达的免疫组织化学标记物。不同胶质瘤实体的特征细胞形态可以通过MAP2免疫反应性来识别，即过程稀疏的少突胶质细胞与密集分枝的星形胶质细胞。在这里，我们描述了map2在各种神经上皮肿瘤和相关肿瘤中的免疫反应模式（n=960）。免疫组化分析得出以下结论：(1)95%的神经胶质肿瘤可识别map2阳性肿瘤细胞的特异性模式；(2)室管膜肿瘤的玫瑰花形成细胞成分不表达MAP2；(3)松果体肿瘤和恶性胚胎肿瘤也具有丰富的MAP2免疫反应性；(4)在神经胶质瘤的肿瘤胶质成分，即神经节胶质瘤中，几乎没有观察到MAP2的表达；(5)恶性胶质肿瘤变体（WHO分级III或IV）与良性肿瘤变体（WHO分级I或II）相比，表现出不同且特异性较低的MAP2染色模式；(6)除黑色素瘤和小细胞肺癌外，MAP2在转移性和非神经上皮性肿瘤中的表达非常罕见；(7) 56例非肿瘤性病变中未检测到胶质细胞MAP2表达。这些数据表明MAP2是低级别神经上皮肿瘤模式识别和鉴别诊断的有价值的诊断工具。
Complex and variable morphological phenotypes pose a major challenge to the histopathological classification of neuroepithelial tumors. This applies in particular for low-grade gliomas and glio-neuronal tumors. Recently, we and others have identified microtubule-associated protein-2 (MAP2) as an immunohistochemical marker expressed in the majority of glial tumors. Characteristic cell morphologies can be recognized by MAP2 immunoreactivity in different glioma entities, i.e., process sparse oligodendroglial versus densely ramified astrocytic elements. Here, we describe MAP2-immunoreactivity patterns in a large series of various neuroepithelial tumors and related neoplasms (n=960). Immunohistochemical analysis led to the following conclusions: (1) specific pattern of MAP2-positive tumor cells can be identified in 95% of glial neoplasms; (2) ependymal tumors do not express MAP2 in their rosette-forming cell component; (3) tumors of the pineal gland as well as malignant embryonic tumors are also characterized by abundant MAP2 immunoreactivity; (4) virtually no MAP2 expression can be observed in the neoplastic glial component of glio-neuronal tumors, i.e. gangliogliomas; (5) malignant glial tumor variants (WHO grade III or IV) exhibit different and less specific MAP2 staining patterns compared to their benign counterparts (WHO grade I or II); (6) with the exception of melanomas and small cell lung cancers, MAP2 expression is very rare in metastatic and non-neuroepithelial tumors; (7) glial MAP2 expression was not detected in 56 non-neoplastic lesions. These data point towards MAP2 as valuable diagnostic tool for pattern recognition and differential diagnosis of low-grade neuroepithelial tumors.