Difference in cytoplasmic localization pattern of neutral mucin among lobular endocervical glandular hyperplasia, adenoma malignum, and common adenocarcinoma of the uterine cervix
Difference in cytoplasmic localization pattern of neutral mucin among lobular endocervical glandular hyperplasia, adenoma malignum, and common adenocarcinoma of the uterine cervix
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小叶状宫颈管腺增生、恶性腺瘤和常见宫颈腺癌中性粘蛋白胞浆定位模式的差异
作者：
I. Hayashi;H. Tsuda;T. Shimoda;Arafumi Maeshima;T. Kasamatsu;Takuro Yamada;R. Tsunematsu
研究中性粘蛋白在宫颈腺上皮小叶增生（LEGH）和宫颈腺癌（CxAd）（包括宫颈微偏腺癌（MDA）或宫颈腺瘤）中的胞浆定位模式是否不同，对13例LEGH病变和53例CxAd肿瘤的福尔马林固定石蜡包埋组织切片进行pH2.5/过碘酸-希夫（AB-PAS）染色，其中MDA肿瘤6例。中性粘蛋白的细胞质定位被分类为“全细胞质模式”，其中中性粘蛋白完全填充细胞质，或作为“顶端模式”，其中中性粘蛋白仅定位于亚表面区域。13例LEGH和19例CxAd（36%）中均检测到胞浆中性粘蛋白模式，其中包括5例MDA。13例LEGH中性粘蛋白均为全胞浆型，19例CxAd中性粘蛋白均为顶端型。34例CxAd，包括1例MDA，AB-PAS染色呈酸性粘蛋白型，呈紫色或蓝色或不染色。在53例CxAd中，单因素和多因素分析表明，心尖中性粘蛋白模式是患者预后较差的指标。中性粘蛋白的胞浆定位检测不仅可用于LEGH与CxAd的鉴别诊断，包括MDA的检测，而且可用于评估CxAd的临床侵袭性。
To investigate whether the cytoplasmic localization pattern of neutral mucin differs between lobular endocervical glandular hyperplasia (LEGH) and cervical adenocarcinoma (CxAd), including minimal-deviation adenocarcinoma (MDA), or adenoma malignum, alcian blue (pH 2.5)/periodic acid-Schiff (AB-PAS) staining was performed to formalin-fixed paraffin-embedded tissue sections of 13 lesions of LEGH and 53 tumors of CxAd, including 6 tumors of MDA. The cytoplasmic localization of neutral mucin was classified as a “whole cytoplasmic pattern,” in which neutral mucin filled the cytoplasm entirely, or as an “apical pattern,” in which neutral mucin was localized in the subsurface area only. Cytoplasmic neutral mucin patterns were detected in all 13 cases of LEGH and in 19 cases (36%) of CxAd, including five cases of MDA. The localization of neutral mucin was always the whole cytoplasmic pattern in 13 cases of LEGH, but was the apical pattern in these 19 cases of CxAd. The other 34 cases of CxAd, including 1 case of MDA, corresponded to the acid mucin pattern stained purple or blue or no staining pattern by AB-PAS. Among the 53 cases of CxAd, the apical neutral mucin pattern was an indicator of poorer patient prognosis by univariate and multivariate analyses. The examination of cytoplasmic localization of neutral mucin might be applicable, not only to differential diagnosis between LEGH and CxAd, including MDA, but also to estimate clinical aggressiveness of CxAd.