Schröder S, Niendorf A, Achilles E, Dietel M, Padberg B C, Beisiegel U, Dralle H, Bressel M, Klöppel G
Institute of Pathology, University Hospital Hamburg-Eppendorf, Federal Republic of Germany.
Virchows Arch A Pathol Anat Histopathol. 1990;417(2):89-96. doi: 10.1007/BF02190525.
The monoclonal antibody D11 is a valuable aid in the accurate typing of adrenal tumours as, in formalin-fixed, paraffin-embedding material, strong nuclear D11 positivity was observed only in adrenocortical cells in 190 neoplasms (including 100 adrenal tumours). This pattern was demonstrated for all zona glomerulosa cells in 27 normal adrenals and for the neoplastic cells of 15 adrenocortical adenomas derived from that zone, as judged from clinically evident hyperaldosteronism. Normal cells of zona fasciculata and reticularis also showed strong diffuse D11 immunostaining and the same nuclear plus cytoplasmic D11 reactivity was evident in 15 benign and malignant adrenocortical neoplasms derived from these zones, documented by hypercortisolism. Cytoplasmic and/or nuclear D11 staining made topohistogenetic typing possible in 15 non-functioning cortical tumours. D11 immunostaining gave negative results in 50 specimens containing normal, hyperplastic and neoplastic adrenomedullary cells. In addition, absence of D11 reactivity was recorded in 4 adrenal metastases of extra-adrenal carcinomas, 5 paragangliomas, 25 primary renal carcinomas and 59 of 60 primary thyroid carcinomas. D11 immunocytochemistry allows the accurate typing of benign and malignant adrenocortical neoplasms, irrespective of histology and function. With this method, primary adrenocortical tumours can be separated from carcinomas metastatic to the adrenal gland, including secondary tumours of similar phenotype (such as renal carcinomas). By exclusion, D11 negativity provides evidence of the medullary origin of primary adrenal tumours even in the absence of clinical, structural, histochemical and conventional immunohistochemical indicators of phaeochromocytoma.
单克隆抗体D11有助于准确鉴别肾上腺肿瘤类型。在福尔马林固定、石蜡包埋的材料中，190例肿瘤（包括100例肾上腺肿瘤）中仅肾上腺皮质细胞出现强核D11阳性。在27个正常肾上腺的所有球状带细胞以及15个源于该带的肾上腺皮质腺瘤的肿瘤细胞中均呈现这种模式，这是根据临床明显的醛固酮增多症判断的。束状带和网状带的正常细胞也显示出强弥漫性D11免疫染色，并且在15个源于这些带的良性和恶性肾上腺皮质肿瘤中，同样的核加胞质D11反应性明显，这由皮质醇增多症证实。细胞质和/或核D11染色使15个无功能皮质肿瘤的组织发生学分型成为可能。D11免疫染色在50个含有正常、增生和肿瘤性肾上腺髓质细胞的标本中呈阴性结果。此外，在4例肾上腺外癌的肾上腺转移瘤、5例副神经节瘤、25例原发性肾癌以及60例原发性甲状腺癌中的59例中记录到无D11反应性。D11免疫细胞化学可准确鉴别良性和恶性肾上腺皮质肿瘤，而不论其组织学和功能如何。通过这种方法，原发性肾上腺皮质肿瘤可与转移至肾上腺的癌区分开来，包括具有相似表型的继发性肿瘤（如肾癌）。通过排除法，即使在缺乏嗜铬细胞瘤的临床、结构、组织化学和传统免疫组织化学指标的情况下，D11阴性也为原发性肾上腺肿瘤的髓质起源提供了证据。
