Kanner William A, Galgano Mary T, Atkins Kristen A
Department of Pathology, University of Virginia Health System, Charlottesville, VA 22901, USA.
Appl Immunohistochem Mol Morphol. 2010 May;18(3):226-30. doi: 10.1097/PAI.0b013e3181c65141.
Podoplanin, D2-40, is often used for highlighting lymphatics. However, it has been described in a variety of normal and neoplastic tissues. We evaluated the expression of D2-40 in breast, salivary gland, skin, and mucosa, all organs rich in myoepithelial cells and basal cells. This study assessed the utility of using D2-40 to highlight basal/myoepithelial cells and to identify potential pitfalls in misinterpretation of lymphatic invasion. Our results showed that myoepithelial cells in breast and salivary gland and basal cells in prostate consistently demonstrate D2-40 immunoreactivity, but typically less intensely than lymphatics. Cutaneous and mucosal-based basal cells also have D2-40 expression, but often in a patchy, focal manner. In addition, many salivary gland tumors and squamous cell carcinomas had strong D2-40 expression, sometimes making distinction of lymphatics versus tumor edge staining difficult. D2-40 is excellent for assessing lymphatic invasion in breast, prostate, and cervix as long as the pathologist is aware of the expression in myoepithelial cells/basal cells to avoid misinterpretation of ductal carcinoma in situ or normal prostate glands or tumor stroma retraction as tumor lymphatic invasion. Given the patchy positivity in basal cells of skin and mucosa and the reactivity in squamous cell carcinoma, D2-40 was not helpful in assessing for microinvasion of squamous cell carcinoma.
血小板源性生长因子结合蛋白（Podoplanin, D2-40）常用于突显淋巴管。然而，它在多种正常组织和肿瘤组织中均有表达。我们评估了D2-40在乳腺、唾液腺、皮肤和黏膜中的表达，这些器官均富含肌上皮细胞和基底细胞。本研究评估了使用D2-40突显基底/肌上皮细胞以及识别淋巴管侵犯误判潜在陷阱的效用。我们的结果显示，乳腺和唾液腺中的肌上皮细胞以及前列腺中的基底细胞始终表现出D2-40免疫反应性，但通常强度低于淋巴管。皮肤和黏膜中的基底细胞也有D2-40表达，但往往呈斑片状、局灶性。此外，许多唾液腺肿瘤和鳞状细胞癌有强烈的D2-40表达，有时难以区分淋巴管染色与肿瘤边缘染色。只要病理学家了解肌上皮细胞/基底细胞中的表达情况，以避免将原位导管癌、正常前列腺腺体或肿瘤基质退缩误判为肿瘤淋巴管侵犯，D2-40对于评估乳腺、前列腺和宫颈的淋巴管侵犯非常出色。鉴于皮肤和黏膜基底细胞的斑片状阳性以及鳞状细胞癌中的反应性，D2-40无助于评估鳞状细胞癌的微浸润。
