Preusser M, Laggner U, Haberler C, Heinzl H, Budka H, Hainfellner J A
Institute of Neurology, Core Unit for Medical Statistics and Informatics, Medical University Vienna, Vienna, Austria.
Histopathology. 2006 Mar;48(4):438-44. doi: 10.1111/j.1365-2559.2006.02359.x.
NeuN is considered to be a marker of neuronal differentiation in brain tumours. Our aim was to perform, for the first time, a systematic and comparative analysis of NeuN expression in all major brain tumour subtypes to provide guidance for the rational use of NeuN immunohistochemistry in diagnostic histopathology.
Anti-NeuN immunohistochemistry was performed on paraffin-embedded biopsy specimens of 106 diffuse astrocytomas, 100 pilocytic astrocytomas, 107 ependymomas, 59 1p-aberrant oligodendroglial neoplasms, 115 glioblastomas, 115 medulloblastomas, 14 gangliogliomas/gangliocytomas and 10 central neurocytomas. We found no NeuN expression in pilocytic astrocytoma, whereas all other investigated tumour subtypes showed focal or widespread expression in varying proportions of cases. Comparing NeuN expression in clear cell tumours, widespread NeuN expression had a positive predictive value of 76.9% (95% confidence interval 46.2, 95.0) for central neurocytoma. Lack of NeuN expression had a positive predictive value of 87.3% (76.5, 94.4) for oligodendroglioma.
Immunohistochemistry can detect NeuN expression in all major brain tumour subtypes except pilocytic astrocytoma. In the individual case, assessment of NeuN expression may be helpful in the differential diagnosis of clear cell primary brain tumours but does not seem to be useful for the differential diagnosis of other brain tumour subtypes.
神经元核抗原（NeuN）被认为是脑肿瘤中神经元分化的标志物。我们的目的是首次对所有主要脑肿瘤亚型中的NeuN表达进行系统和比较分析，为NeuN免疫组化在诊断组织病理学中的合理应用提供指导。
对106例弥漫性星形细胞瘤、100例毛细胞型星形细胞瘤、107例室管膜瘤、59例1p异常少突胶质细胞瘤、115例胶质母细胞瘤、115例髓母细胞瘤、14例节细胞胶质瘤/节细胞神经瘤和10例中枢神经细胞瘤的石蜡包埋活检标本进行抗NeuN免疫组化检测。我们发现毛细胞型星形细胞瘤中无NeuN表达，而所有其他研究的肿瘤亚型在不同比例的病例中显示局灶性或广泛表达。在透明细胞肿瘤中比较NeuN表达，广泛的NeuN表达对中枢神经细胞瘤的阳性预测值为76.9%（95%置信区间46.2, 95.0）。NeuN表达缺失对少突胶质细胞瘤的阳性预测值为87.3%（76.5, 94.4）。
免疫组化可检测除毛细胞型星形细胞瘤外的所有主要脑肿瘤亚型中的NeuN表达。在个别病例中，评估NeuN表达可能有助于透明细胞原发性脑肿瘤的鉴别诊断，但似乎对其他脑肿瘤亚型的鉴别诊断无用。
