Composite carcinoma-carcinoid tumors of the gastrointestinal tract. A morphologic, histochemical, and immunocytochemical study.
Composite carcinoma-carcinoid tumors of the gastrointestinal tract. A morphologic, histochemical, and immunocytochemical study.
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胃肠道复合癌-类癌肿瘤。
DOI：
10.1093/ajcp/84.2.137
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发表时间：
1985
影响因子：
3.5
通讯作者：
James,LP
中科院分区：
文献类型：
--
作者：
Klappenbach,RS;Kurman,RJ;Sinclair,CF;James,LP
本文对20例单纯胃肠道类癌、腺癌和两者组成的混合性肿瘤，即所谓的癌-类癌复合瘤(CCC)进行了形态、组织化学和免疫细胞化学研究，以探讨其形态与癌胚抗原(CEA)、5-羟色胺和一组多肽激素(降钙素、高血糖素、胰岛素、胃泌素、生长抑素和促肾上腺皮质激素)的免疫细胞化学定位的关系。对5例纯癌、7例纯腺癌和8例来自胃、小肠、阑尾和结肠的CCC石蜡切片进行了粘液胺染色、银染和过氧化物酶-抗过氧化物酶技术研究。8例CCC均为粘蛋白阳性，4例嗜银，3例嗜银。CEA存在于所有8例中，5-羟色胺存在于7例，降钙素存在于1例。没有发现其他神经激素肽。5-羟色胺和CEA的分布与形态基本一致，但有2例不一致，即5-羟色胺不总是局限于类癌区域，CEA不总是局限于癌区域。所有五种纯类癌均显示5-羟色胺位于胞浆内，而没有一种含有胞浆内CEA。在两个病例中，CEA仅存在于腺泡腔内。7例结肠腺癌均为嗜银和亲银阴性。细胞质和腺腔内均含有CEA。没有一个含有5-羟色胺。这些神经激素肽在纯腺癌和类癌中都没有定位。本研究发现，在表现腺癌和类癌形态的胃肠道肿瘤中，CEA和5-羟色胺的免疫细胞化学定位证实了它们的双向分化，并证明了“复合癌-类癌”的名称是正确的。
A morphologic, histochemical, and immunocytochemical study of 20 cases of pure gastrointestinal carcinoids, adenocarcinomas, and mixed neoplasms composed of both elements, so-called composite carcinoma–carcinoid tumors (CCC), was undertaken in order to correlate the morphologic patterns with the immunocytochemical localization of carcinoembryonic antigen (CEA), serotonin, and a battery of polypeptide hormones (calcitonin, glucagon; insulin, gastrin, somatostatin, and adrenocorticotropin |ACTH]). Paraffin sections from five pure carcinoids, seven pure adenocarcinomas, and eight CCC from the stomach, small bowel, appendix, and colon were studied with mucicarmine, silver impregnation stains, and a peroxidase–anti-peroxidase technic. Of the eight CCC, all were mucin positive, four were argyrophilic, and three were argentaffin positive. CEA was present in all eight, serotonin in seven, and calcitonin in one. No other neurohormonal peptides were demonstrated. The distribution of serotonin and CEA generally corresponded to the morphologic pattern, but discordance was observed in two cases,i.e., serotonin was not always localized to areas of carcinoid and CEA not always confined to areas of carcinoma. All five pure carcinoids demonstrated intracytoplasmic localization of serotonin, whereas none contained intracytoplasmic CEA. In two cases, CEA was present within acinar lumens only. The seven colonic adenocarcinomas were argyrophil and argentaffin negative. All contained CEA within the cytoplasm and in gland lumens. None contained serotonin. None of the neurohormonal peptides was localized in either pure adenocarcinomas or carcinoids. This study reveals that among gastrointestinal neoplasms displaying morphologic patterns of adenocarcinoma and carcinoid, immunocytochemical localization of CEA and serotonin confirms their bidirectional differentiation and justifies the designation “composite carcinoma–carcinoid.”