Reid M M, Wallis J P, McGuckin A G, Pearson A D, Malcolm A J
Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne.
J Clin Pathol. 1991 Jun;44(6):483-6. doi: 10.1136/jcp.44.6.483.
The ability to detect infiltration in bone marrow biopsy specimens from patients with disseminated neuroblastoma was assessed by immunohistological and routine histological methods. Frozen cores from 33 staging procedures were tested with UJ13A and UJ127.11. Immunopositive tumour cells were found in 10 of 17 staging procedures in which tumour was detectable by routine histological methods. Positive cells or stromal material were also found in eight of 12 staging procedures in which distorted architecture and fibrosis, but no obvious tumour, had been noted. Paraffin wax embedded cores from 29 of the same staging procedures were tested with antibodies against neurone specific enolase and neurofilament. Only a single core reacted with anti-neurofilament antibody. Neurone specific enolase positive cells or stromal material were found in nine of 15 staging procedures in which obvious tumour was detectable. Although these immunohistochemical techniques proved inferior to routine histology in their ability to detect obvious tumour, the demonstration of immunopositive stromal tissue which was not frankly malignant supports the view that distorted, fibrotic marrow may reflect persistence of neuroectodermal tissue and justifies its distinction from normal marrow when reporting the response to treatment.
采用免疫组织学和常规组织学方法评估从播散性神经母细胞瘤患者骨髓活检标本中检测浸润的能力。对33例分期手术的冰冻组织块用UJ13A和UJ127.11进行检测。在17例分期手术中，通过常规组织学方法可检测到肿瘤，其中10例发现免疫阳性肿瘤细胞。在12例分期手术中，虽未发现明显肿瘤，但可见结构扭曲和纤维化，其中8例发现阳性细胞或基质物质。对相同的29例分期手术的石蜡包埋组织块用抗神经元特异性烯醇化酶和神经丝抗体进行检测。仅1个组织块与抗神经丝抗体发生反应。在15例可检测到明显肿瘤的分期手术中，9例发现神经元特异性烯醇化酶阳性细胞或基质物质。尽管这些免疫组化技术在检测明显肿瘤方面被证明不如常规组织学，但免疫阳性基质组织并非明显恶性，这支持了结构扭曲、纤维化的骨髓可能反映神经外胚层组织持续存在的观点，并且在报告治疗反应时将其与正常骨髓区分开来是合理的。
