Makishi S, Kinjo T, Sawada S, Chinen K, Hirayasu T, Hamada T, Saito K, Iwamasa T
Division of Pathology and Cell Biology, Graduate School and Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
J Clin Pathol. 2006 Jan;59(1):95-100. doi: 10.1136/jcp.2005.026237.
Morules have been reported in pulmonary blastoma (PB), well differentiated fetal adenocarcinoma of the lung (WDFA), and uterine endometrioid carcinoma (EC), and rarely in other carcinomas. beta Catenin gene mutation has been associated with morule formation.
To compare and clarify the cellular characteristics of morules in carcinomas in various organs and show that morules are distinct from epithelial cellular nodules.
Twenty tumours were studied: two PBs, three WDFAs, three papillary lung adenocarcinomas, 11 ECs, and one papillary thyroid carcinoma. Numerous epithelial cell, oncofetal, and neuropeptide antibodies were used for immunohistochemistry. beta Catenin gene mutation was investigated.
Morules in PBs and ECs were uniform cell clusters distinct from squamous differentiation. All were immunonegative for epithelial cell and oncofetal antigens, but those in ECs were positive for neurone specific enolase gamma (NSEgamma). Synaptophysin, encephalin, and somatostatin were sporadically immunopositive in PB morules. Morules were not seen in the other carcinomas and WDFAs, although morule-like features closely resembling morules histopathologically were seen. These were positive for epithelial cell and oncofetal antigens, and showed squamous differentiation. Their nuclei were more atypical and slightly larger than those in morules. Morule-like features were seen in WDFAs. beta Catenin gene mutation was demonstrated in one EC and PB, and in two WDFAs.
Morules were non-epithelial cell clusters showing neuronal differentiation. There were two types: endometrioid type, expressing NSEgamma, and blastoma type, expressing neuropeptides. In contrast, similar morule-like features were epithelial nodules. Although the number of cases was small, the presence of morules showed no clear prognostic correlations.
桑葚体已在肺母细胞瘤（PB）、肺高分化胎儿腺癌（WDFA）和子宫内膜样癌（EC）中被报道，在其他癌中罕见。β-连环蛋白基因突变与桑葚体形成有关。
比较并阐明不同器官癌中桑葚体的细胞特征，并表明桑葚体与上皮细胞结节不同。
研究了20例肿瘤：2例PB、3例WDFA、3例乳头状肺腺癌、11例EC和1例乳头状甲状腺癌。使用多种上皮细胞、癌胚和神经肽抗体进行免疫组织化学检测。研究β-连环蛋白基因突变情况。
PB和EC中的桑葚体是与鳞状分化不同的均匀细胞簇。所有桑葚体对上皮细胞和癌胚抗原均呈免疫阴性，但EC中的桑葚体对神经元特异性烯醇化酶γ（NSEγ）呈阳性。突触素、脑啡肽和生长抑素在PB桑葚体中偶见免疫阳性。在其他癌和WDFA中未见桑葚体，尽管可见组织病理学上与桑葚体非常相似的桑葚体样特征。这些对上皮细胞和癌胚抗原呈阳性，并显示鳞状分化。它们的细胞核比桑葚体中的更不典型且稍大。WDFA中可见桑葚体样特征。在1例EC和PB以及2例WDFA中检测到β-连环蛋白基因突变。
桑葚体是非上皮细胞簇，显示神经元分化。有两种类型：子宫内膜样型，表达NSEγ，和母细胞瘤型，表达神经肽。相比之下，类似的桑葚体样特征是上皮结节。尽管病例数较少，但桑葚体的存在未显示出明确的预后相关性。
