CD56 expression in ovarian granulosa cell tumors, and its diagnostic utility and pitfalls
CD56 expression in ovarian granulosa cell tumors, and its diagnostic utility and pitfalls
复制标题
DOI：
10.1016/j.ygyno.2007.05.020
复制
发表时间：
2007-10-01
影响因子：
4.7
通讯作者：
Tsuneyoshi, Masazumi
中科院分区：
文献类型：
--
作者：
Ohishi, Yoshihiro;Kaku, Tsunehisa;Tsuneyoshi, Masazumi
目标。本研究的目的是研究CD56在卵巢颗粒细胞瘤及其形态模拟中的染色，以确定CD56染色在诊断中的价值。材料和方法。采用单克隆抗cd56抗体对82例卵巢肿瘤、26例卵巢外肿瘤和11例正常卵巢组织进行免疫组化染色。卵巢肿瘤包括颗粒细胞瘤32例，支持基质细胞瘤3例，纤维囊肿瘤14例，类癌6例，大细胞神经内分泌癌1例，子宫内膜样腺癌17例，低分化浆液腺癌9例。卵巢外肿瘤包括22例子宫内膜间质肉瘤和4例肺小细胞癌。正常卵巢包含47个卵泡。32例颗粒细胞瘤、3例支持间质细胞瘤、4例小细胞癌、1例大细胞神经内分泌癌、14例纤维囊肿瘤中11例、6例类癌中5例、22例子宫内膜间质肉瘤中17例、9例低分化浆液腺癌中7例CD56阳性。17例子宫内膜样腺癌和47例卵泡未见免疫反应细胞。除纤维鞘瘤可见模糊的细胞质染色外，其余免疫反应细胞均呈膜性染色。CD56被称为神经内分泌标志物，是颗粒细胞肿瘤的敏感标志物，但由于颗粒细胞肿瘤和神经内分泌肿瘤可能在形态上相似，因此CD56阳性代表了一个重要的诊断缺陷。CD56可用于区分颗粒细胞瘤和正常卵巢卵泡或子宫内膜样腺癌。纤维鞘瘤中缺乏膜性CD56表达可能有助于其与颗粒细胞瘤的区分。然而，CD56在鉴别颗粒细胞瘤和低分化癌或子宫内膜间质肉瘤方面的作用有限。正确和谨慎地解释CD56的表达，有助于更准确地诊断颗粒细胞瘤。(C) 2007爱思唯尔公司版权所有。
Objective. The purpose of this study is to investigate CD56 staining in ovarian granulosa cell tumor and its morphological mimics in order to determine the value of CD56 staining in a diagnostic setting.Materials and methods. Tissue samples taken from 82 ovarian tumors, 26 extra-ovarian tumors and 11 normal ovaries were immunohistochemically stained using monoclonal anti-CD56 antibody. Ovarian tumors comprised 32 granulosa cell tumors, 3 Sertoli-stromal cell tumors, 14 fibrothecomas, 6 carcinoid tumors, 1 large cell neuroendocrine carcinoma, 17 endometrioid adenocarcinomas and 9 poorly differentiated serous adenocarcinomas. Extra-ovarian tumors comprised 22 uterine endometrial stromal sarcomas and 4 pulmonary small cell carcinomas. Normal ovaries contained 47 ovarian follicles.Results. All of the 32 granulosa cell tumors, all of the 3 Sertoli-stromal cell tumors, all of the 4 small cell carcinomas, 1 of 1 large cell neuroendocrine carcinoma, 11 of 14 fibrothecomas, 5 of 6 carcinoid tumors, 17 of 22 endometrial stromal sarcomas and 7 of 9 poorly differentiated serous adenocarcinomas were positive for CD56. No immunoreactive cells were observed in 17 endometrioid adenocarcinomas or 47 ovarian follicles. All the immunoreactive cells showed membranous staining except for fibrothecomas where vague cytoplasmic staining was seen.Conclusion. CD56, known as a neuroendocrine marker, is a sensitive marker of granulosa cell tumors, but since granulosa cell tumors and neuroendocrine tumors may be morphologically similar, CD56 positivity represents a significant diagnostic pitfall. CD56 is useful in distinguishing between granulosa cell tumor and normal ovarian follicles or endometrioid adenocarcinoma. Lack of membranous CD56 expression in fibrothecoma may help differentiate it from granulosa cell tumor. However, CD56 is of limited use for distinguishing between granulosa cell tumor and poorly differentiated carcinoma or endometrial stromal sarcoma. Appropriate and cautious interpretation of CD56 expression should lead to a more accurate diagnosis of granulosa cell tumor. (C) 2007 Elsevier Inc. All rights reserved.