Histopathological re-evaluation of pancreatic neoplasms : Special reference to immunohistochemistry and molecular biology

我们对胰腺肿瘤（包括导管内乳头状粘液性肿瘤（IPMN）、内分泌肿瘤、胰腺上皮内瘤变（PanIN）、胰腺癌等）进行了组织病理学重新评价2001年至2003年，采用免疫组织化学和分子生物学方法。在IPMN中，轻度高绒毛结构和核重叠是鉴别导管内乳头状黏液腺瘤（IPMA）、导管内乳头状黏液瘤、交界性肿瘤（IPMB）和导管内乳头状黏液癌（IPMC）的重要标志。关于内分泌肿瘤（包括良性和恶性肿瘤），到目前为止，似乎没有有用的HE结果来诊断恶性肿瘤，虽然我们发现了几例内分泌肿瘤伴导管分化。MUC 1被认为是PanIN病变中恶性肿瘤的良好标志物。所有PanIN病例均为MUC 2阴性。胰腺癌中p53和MIB-1的表达多为阳性，且核变性明显。有几例分化良好的腺癌表现出较少的非典型特征。在这种情况下，腺内坏死碎片是腺癌的诊断线索。

We performed the histopathological re-evaluation of pancreatic neoplasms (including intraductal papillary mucinous neoplasms (IPMN), endocrine tumors, pancreatic intraepithelial neoplasia (PanIN), pancreatic cancers, et al.) by using immunohistochemistry and molecular biology from 2001 to 2003. Then, we tried to find the important hematoxylin-eosin (HE) staining findings related to the above mentioned results.In IPMN cases, slightly high villous architecture and nuclear overlapping were the most important findings to differentiate among intraductal papillary mucinous adenoma (IPMA), intraductal papillary mucinous neoplasm, borderline (IPMB), and intraductal papillary mucinous carcinoma (IPMC). Regarding endocrine tumors (including both benign and malignant tumors), so far there seemed to be no useful HE findings to diagnose malignant ones, although we found several cases of endocrine tumor with ductal differentiation. MUC1 was thought to be a good marker for malignancy in PanIN lesions. All cases of PanIN was negative for MUC2. On the other hand, in cases of pancreatic cancers, most cases revealed positive staining of p53 and MIB-1, and the nuclear atypia was obvious in such cases. There were several cases of well differentiated adenocarcinoma showing less atypical features. In such cases, intraglandular necrotic debris was a diagnostic clue to adenocarcinoma.