Perkins P L, McLeod M K, Jin L, Fukuuchi A, Cho K J, Thompson N W, Lloyd R V
Department of Pathology, University of Michigan Medical Center, Ann Arbor 48109-0054.
Diagn Mol Pathol. 1992 Sep;1(3):155-64.
Gastrinomas from 25 patients were examined by immunohistochemistry (IHC) and in situ hybridization histochemistry (ISH). Most patients (84%) presented with the Zollinger-Ellison syndrome. Six had multiple endocrine neoplasia type I (MEN-I). Twelve patients (48%) had duodenal primaries and 11 of 12 of these had metastases to regional lymph nodes and/or liver in spite of the small sizes of the primary tumors (mean size of 0.9 cm). Five patients had pancreatic gastrinomas and eight patients had metastatic tumor in regional lymph nodes or liver at surgery but a primary was not found. IHC and ISH analyses showed that all cases were positive for gastrin protein and 24 of 25 (96%) expressed gastrin mRNA that was easily detected in formalin-fixed, paraffin-embedded tissue sections. Both benign and malignant tumors expressed alpha subunit of human chorionic gonadotropin protein (alpha-HCG). However, only malignant gastrinomas (29%) expressed adrenocorticotropic hormone protein or proopiomelanocortin (POMC) mRNA. ISH and Northern hybridization analysis revealed that chromogranin A mRNA was the most common member of the chromogranin/secretogranin (Cg/Sg) family which was expressed in both benign and malignant gastrinomas. These results indicate that duodenal gastrinomas are common in both sporadic and MEN-1-associated cases, and small duodenal primaries may be associated with extensive regional lymph node and liver metastases. Expression of ACTH/POMC protein and mRNA was consistently associated only with malignant gastrinomas while gastrin protein, gastrin mRNA and Cgs/Sgs mRNAs were readily detected in both benign and malignant gastrinomas.
对25例胃泌素瘤患者的肿瘤组织进行免疫组织化学（IHC）和原位杂交组织化学（ISH）检测。大多数患者（84%）表现为卓艾综合征。6例患有I型多发性内分泌腺瘤病（MEN-I）。12例患者（48%）的肿瘤原发于十二指肠，其中11例尽管原发肿瘤较小（平均大小为0.9 cm），但已出现区域淋巴结和/或肝脏转移。5例患者患有胰腺胃泌素瘤，8例患者在手术时发现区域淋巴结或肝脏有转移瘤，但未找到原发灶。IHC和ISH分析显示，所有病例的胃泌素蛋白均呈阳性，25例中有24例（96%）表达胃泌素mRNA，在福尔马林固定、石蜡包埋的组织切片中易于检测到。良性和恶性肿瘤均表达人绒毛膜促性腺激素蛋白α亚基（α-HCG）。然而，只有恶性胃泌素瘤（29%）表达促肾上腺皮质激素蛋白或阿黑皮素原（POMC）mRNA。ISH和Northern杂交分析显示，嗜铬粒蛋白A mRNA是嗜铬粒蛋白/分泌粒蛋白（Cg/Sg）家族中最常见的成员，在良性和恶性胃泌素瘤中均有表达。这些结果表明，十二指肠胃泌素瘤在散发性和MEN-1相关病例中均很常见，十二指肠原发小肿瘤可能与广泛的区域淋巴结和肝脏转移有关。促肾上腺皮质激素/阿黑皮素原蛋白和mRNA的表达仅与恶性胃泌素瘤相关，而胃泌素蛋白、胃泌素mRNA和Cg/Sg mRNA在良性和恶性胃泌素瘤中均易于检测到。
