Zhao Ye, Zheng Yage, Zhang Lihui, Yao Tian, Wu Lanyan
Dept. of Stomatology, Datong No.3 People's Hospital, Datong 037008, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2011 Dec;29(6):604-9.
To study clinicopathological features, diagnosis, differential diagnosis of oral Langerhans cell histiocytosis (LCH), retrospective clinicopathologic study was carried on and a variety of immune phenotype were detected.
The clinicopathological features of 29 cases of oral LCH were analyzed. The immunohistochemical staining of S-100 protein, CD1a, CD83 and Ki-67 were used in above cases by immunohistochemical streptavidin-biotin peroxidase (SP) and Elivison two-step method. Statistical analysis was adopted for the results.
Of the 29 cases of LCH, the expression of S-100 protein and CD1a were positive in 24 cases and negative in 5 cases, so 5 cases were excluded from the diagnosis of LCH. Among 24 cases of LCH, 15 patients were male and 9 were female. The median age was 7.50 years. 14 lesions were in the mandible, 5 were in the maxilla and 5 involved the mandible and maxilla. 9 cases were in stage I, 13 in stage II and 2 in stage III, according to Bartnick classification. Immunohistochemistry showed all 24 cases staining for S-100 protein and CD1a were positive. Comparing with maxillofacial lesions involved soft tissue, Ki-67 positive rate was lower and CD83 positive rate was higher in maxillofacial single bone lesion.
The immunohistochemical staining of S-100 protein and CD1a are important for the diagnosis of LCH. Maxillofacial bone single LCH might have lower proliferative activity and a higher state of maturity. Maxillofacial LCH involved soft tissue might have a higher proliferative activity and a lower state of maturity.
通过回顾性临床病理研究并检测多种免疫表型,探讨口腔朗格汉斯细胞组织细胞增多症(LCH)的临床病理特征、诊断及鉴别诊断。
分析29例口腔LCH的临床病理特征。采用免疫组织化学链霉亲和素-生物素过氧化物酶(SP)法及Elivison两步法对上述病例进行S-100蛋白、CD1a、CD83及Ki-67免疫组化染色,并对结果进行统计学分析。
29例LCH中,S-100蛋白和CD1a表达阳性24例,阴性5例,故将5例排除在LCH诊断之外。24例LCH中,男性15例,女性9例。中位年龄为7.50岁。14处病变位于下颌骨,5处位于上颌骨,5处累及下颌骨和上颌骨。根据Bartnick分类,9例为Ⅰ期,13例为Ⅱ期,2例为Ⅲ期。免疫组化显示24例S-100蛋白和CD1a染色均为阳性。与累及软组织的颌面病变相比,颌面单骨病变的Ki-67阳性率较低,CD83阳性率较高。
S-100蛋白和CD1a免疫组化染色对LCH诊断具有重要意义。颌面骨单发性LCH可能增殖活性较低,成熟度较高。累及软组织的颌面LCH可能增殖活性较高,成熟度较低。