Granberg Dan, Skogseid Britt, Welin Staffan, Orlefors Håkan, Oberg Kjell, Wilander Erik
Department of Endocrine Oncology, University Hospital, Uppsala, Sweden.
Acta Oncol. 2006;45(1):23-7. doi: 10.1080/02841860500367434.
In a substantial proportion of cases with endocrine malignant disease the primary lesion cannot be localised and the pathologist hesitates upon the origin of the tumour. Well differentiated neuroendocrine carcinomas of the small bowel can usually be identified by the strong serotonin immunoreactivity, but foregut carcinoids may also stain positive for serotonin and the differential diagnosis between the various foregut tumours may be difficult. We examined if immunostaining for gastrin-releasing-peptide (GRP) may aid in establishing the origin of an unknown neuroendocrine tumour. Tumour tissue from 79 patients (27 lung carcinoids, 4 thymic carcinoids, 4 gastric neuroendocrine tumours, 17 pancreatic well differentiated neuroendocrine carcinomas, 1 duodenal well differentiated neuroendocrine tumour and 26 well differentiated neuroendocrine carcinomas of the small bowel) were immunostained with antibodies against GRP and serotonin. Positive staining for GRP was found in 12/27 lung carcinoids. All other tumour types were consistently GRP-negative (p?<?0.0001). We conclude that immunostaining for GRP may aid in defining the origin of the tumour, and that GRP-immunoreactivity increases the suspicion of a lung carcinoid.
在相当一部分内分泌恶性疾病病例中，原发灶无法定位，病理学家对肿瘤的起源感到迟疑。小肠高分化神经内分泌癌通常可通过强烈的血清素免疫反应性得以识别，但前肠类癌对血清素也可能呈阳性染色，且各种前肠肿瘤之间的鉴别诊断可能存在困难。我们研究了胃泌素释放肽（GRP）免疫染色是否有助于确定未知神经内分泌肿瘤的起源。对79例患者的肿瘤组织（27例肺类癌、4例胸腺类癌、4例胃神经内分泌肿瘤、17例胰腺高分化神经内分泌癌、1例十二指肠高分化神经内分泌肿瘤以及26例小肠高分化神经内分泌癌）进行GRP和血清素抗体免疫染色。在12/27例肺类癌中发现GRP阳性染色。所有其他肿瘤类型均始终为GRP阴性（p＜0.0001）。我们得出结论，GRP免疫染色可能有助于确定肿瘤的起源，且GRP免疫反应性增加了肺类癌的可疑性。
