Immunohistochemical study of mucin expression in periampullary adenomyoma
Immunohistochemical study of mucin expression in periampullary adenomyoma
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DOI：
10.1007/s00534-009-0176-5
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发表时间：
2010-05-01
影响因子：
3
通讯作者：
Yonezawa, Suguru
中科院分区：
文献类型：
--
作者：
Higashi, Michiyo;Goto, Masamichi;Yonezawa, Suguru
壶腹区域的良性肿瘤和肿瘤样病变并不常见，而腺肌瘤（AM）和腺肌瘤性增生（AMH）则极为罕见。如果这些病变引起胆道阻塞，手术治疗是必要的。此外，通过标准的内窥镜活检和细胞病理学分析来鉴别癌中的AM和AMH往往很困难，这可能会显示出不同的发现，导致有时进行不必要的手术。对壶腹周围AM和AMH进行免疫组化（IHC）分析。在这两种类型的病变中，上皮腺细胞（EGCs）均表现为MUC6的弥漫性表达和HIK1083的局灶性表达，主要在内部区域，MUC5AC的局灶性表达，主要在表面。EGCs未显示MUC1或MUC4的表达，这两种蛋白在我们之前的一系列胰胆管肿瘤的粘蛋白表达研究中被确定为恶性肿瘤标志物。正常壶腹周围粘膜弥漫阳性的CK7在AM和AMH的EGCs中表达降低。综合评估IHC结果可能有效地检测AM和AMH，也可以区分壶腹周围良性病变，如AM和AMH，从壶腹腺癌，从而避免过度手术。
Benign tumors and tumor-like conditions in the ampullary area are uncommon, and there are extremely rare cases of adenomyoma (AM) and adenomyomatous hyperplasia (AMH). Surgical treatment is necessary if these lesions cause biliary obstruction. In addition, the differential diagnosis of AM and AMH from carcinoma is often difficult by standard endoscopic biopsy and cytopathological analysis that may show differential findings, resulting in unnecessary surgeries sometimes being performed.Immunohistochemical (IHC) analysis of periampullary AM and AMH was performed.For both types of lesions, epithelial glandular cells (EGCs) showed diffuse expression of MUC6 and focal expression of HIK1083, mainly in the inner region, and focal expression of MUC5AC, mainly at the surface. The EGCs showed no expression of MUC1 or MUC4, both of which were identified as malignant tumor markers in our previous series of mucin expression studies in pancreatobiliary tumors. The expression of CK7, which was diffusely positive in normal periampullary mucosa, was decreased in the EGCs of AM and AMH.A combined evaluation of IHC findings may be effective in the detection of AM and AMH, and also in distinguishing benign periampullary lesions, such as AM and AMH, from ampulla of Vater adenocarcinoma, thus avoiding excessive surgery.