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

2001年至2003年，我们采用免疫组织化学和分子生物学方法对胰腺肿瘤（包括导管内乳头状粘液瘤（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估。然后，我们试图找到与上述结果相关的重要苏木精-伊红（HE）染色结果。在IPMN病例中，略高的绒毛结构和核重叠是区分导管内乳头状粘液腺瘤（IPMA）、导管内乳头状粘液瘤、交界性（IPMB）和导管内乳头状粘液癌（IPMC）的最重要的表现。对于内分泌肿瘤（包括良性和恶性肿瘤），尽管我们发现了几例具有导管分化的内分泌肿瘤，但迄今为止似乎没有有用的HE检查结果来诊断恶性肿瘤。MUC1被认为是PanIN病变恶性的良好标志。PanIN均为MUC2阴性。另一方面，在胰腺癌中，大多数病例p53和MIB-1染色阳性，核异型性明显。有几例高分化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.