Nuclear β-catenin accumulation as reliable marker for the differentiation between cystic craniopharyngiomas and Rathke cleft cysts:: A clinico-pathologic approach
Nuclear β-catenin accumulation as reliable marker for the differentiation between cystic craniopharyngiomas and Rathke cleft cysts:: A clinico-pathologic approach
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DOI：
10.1097/01.pas.0000213328.64121.12
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发表时间：
2006-12-01
影响因子：
5.6
通讯作者：
Buslei, Rolf
中科院分区：
文献类型：
--
作者：
Hofmann, Bernd M.;Kreutzer, Juergen;Buslei, Rolf
鞍区囊性病变，即颅咽管瘤（CP）和大鼠样裂囊肿（RCC）的临床和组织病理学鉴别具有挑战性，并且对于两种实体的可变临床表现和适应的手术治疗策略至关重要。在这里，我们回顾性地评估了81例鞍区囊性肿瘤患者的临床病理结果。所有患者均接受经蝶或经颅切除术。手术标本的显微镜检查确定CP 51例，RCC 30例。在用于组织病理学分析的免疫组化标记蛋白质组中，仅在CP中可检测到P-连环蛋白的核积聚。根据组织病理学和免疫组化分析，临床表现（性别，年龄，眼科和内分泌缺陷），影像学（肿瘤的位置，大小和钙化），以及术中获得的囊肿内容物的描述进行了回顾性评价。在单纯囊性Cps中，等信号在T-1加权磁共振成像中更常见，而在计算机断层扫描中肿瘤包膜钙化更常见。此外，RCC的大小较小，这种肿瘤实体更经常位于鞍内。异常（核）的P-连环蛋白免疫组化染色，然而，作为最可靠的因素之间的纯粹囊性CP和RCC的分化，而肿瘤的位置，肿瘤的大小，和钙化的肿瘤包膜不太一致的参数。这些数据与这些相关组织病理学实体相关的不同致病途径是相容的。
Clinical and histopathologic differentiation of cystic lesions from the sellar region, that is, craniopharyngiornas (CPs) and Ratlike cleft cysts (RCCs), is challenging and has paramount importance with respect to variable clinical manifestation and adapted surgical treatment strategies in both entities. Here, we retrospectively evaluated clinico-pathologic findings in 81 patients presenting with a cystic tumor located in the sellar region. All patients underwent transsphenoidal or transcranial resections. Microscopic inspection of surgical specimens identified CP in 51 patients, and RCC in 30 patients. Amongst the panel of immunohistochemical marker proteins used for histopathologic analysis, nuclear accumulation of P-catenin was detectable only in CP. On the basis of the histopathologic and immunohistochemical analysis, clinical presentation (sex, age, ophthalmologic, and endocrinologic deficits), imaging (tumor location, size, and calcification), as well as a description of cyst contents obtained during operation were retrospectively evaluated. In purely cystic Cps, an isointense signal was more frequent in T-1-weighted magnetic resonance images and calcification of the tumor capsule in computed tomography scans. In addition, the size of RCC was smaller and this tumor entity was more often located within the sella. Aberrant (nuclear) immunohistochemical staining for P-catenin appeared, however, as most reliable factor for the differentiation between purely cystic CPs and RCCs, whereas tumor location, tumor size, and calcification of the tumor capsule were less consistent parameters. The data are compatible with distinct pathogenic pathways associated with these related histopathologic entities.