Mucinous cystic tumor of the pancreas: immunohistochemical assessment of "ovarian-type stroma".
Mucinous cystic tumor of the pancreas: immunohistochemical assessment of "ovarian-type stroma".
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胰腺粘液性囊性肿瘤：“卵巢型基质”的免疫组织化学评估。
DOI：
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
M. Tsuneyoshi
中科院分区：
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作者：
A. Izumo;K. Yamaguchi;T. Eguchi;K. Nishiyama;Hidetaka Yamamoto;H. Yonemasu;T. Yao;Masao Tanaka;M. Tsuneyoshi
世界卫生组织对胰腺外分泌肿瘤进行了新的组织病理学分类，现将卵巢间质(OS)纳入胰腺粘液性囊性肿瘤(MCT-P)的定义。本研究观察MCT-P的临床病理表现，并用免疫组织化学方法观察“OS”在MCT-P中的作用。对34例MCT-P进行了临床病理检查，其中腺瘤28例，交界性肿瘤2例，腺癌4例。应用免疫组织化学方法研究了34例卵巢粘液性囊性肿瘤(MCTs-O)、10例常规胰腺癌和6例正常卵巢间质中的“OS”。34个MCT-P几乎全部位于中年女性的胰体尾部。组织学上，11/34(32.4%)“OS”细胞出现黄素化。免疫组织化学显示，MCT-O中的OS细胞和间质细胞的阳性率相似，分别为：Calponin(34/34和9/10)、h-caldesmon(28/34和8/10)、α-抑制素(29/34和9/10)、雌激素受体(21/34和6/10)和孕激素受体(28/34和9/10)。人绒毛膜促性腺激素(HCG)在MCT-P的部分肿瘤上皮细胞呈阳性(21/34，61.8%)。本研究提示MCT在中年女性胰腺远端占优势。免疫组织化学和组织学结果表明，MCT-P的“OS”与MCT-O的间质具有相同的特征。上述结果还提示，肿瘤上皮细胞产生的hCG可能在MCT-P间质黄素化过程中起重要作用。因此，我们认为MCT-P有可能起源于胎儿发育早期残留的原始性腺细胞，这些细胞迁移到了胰岛。
The new histopathological classification of exocrine pancreatic tumors by the World Health Organization, now includes "ovarian-type stroma" ("OS") in the definition of mucinous cystic tumor of the pancreas (MCT-P). This study investigated the clinicopathological findings of the MCT-P according to WHO classification and scrutinize the function of "OS" in MCT-P immunohistochemically. Thirty-four cases of MCT-P (28 adenomas, 2 borderline tumors and 4 adenocarcinomas) were examined clinicopathologically. The "OS" of 34 MCTs-P were studied immunohistochemically and compared with the stroma of 10 mucinous cystic tumors of the ovary (MCTs-O), 10 conventional pancreatic carcinomas and 6 normal ovaries. Almost all 34 MCTs-P were located in the body-tail of the pancreas of middle-aged women. Histologically the "OS" cells exhibited luteinization in 11/34 (32.4%). Immunohistochemically, both "OS" cells and the stromal cells in MCT-O showed similar positivity rates; calponin (34/34 and 9/10), h-caldesmon (28/34 and 8/10), alpha-inhibin (29/34 and 9/10), estrogen-receptor (21/34 and 6/10) and progesterone-receptor (28/34 and 9/10, respectively). Some neoplastic epithelial cells of MCT-P were positive for human chorionic gonadotropin (hCG) (21/34, 61.8%). This study indicates the predominance of MCT in the distal pancreas of middle-aged women. Furthermore, the immunohistochemical and histological results demonstrate that the "OS" of MCT-P and the stroma of MCT-O share the same characteristics. The results also suggested that the hCG produced by the neoplastic epithelium probably plays an important role in the luteinization of the stroma of MCT-P. We therefore conclude there is a possibility that MCT-P originates from the left remnant primordial gonadal cells which migrated to the pancreatic anlage during the early development of the fetus.