The New York Eye and Ear Infirmary, New York, New York.
New York Institute of Technology College of Osteopathic Medicine, New York, New York.
Ophthalmology. 2014 Apr;121(4):964-71. doi: 10.1016/j.ophtha.2013.10.041. Epub 2013 Nov 28.
To determine the efficacy of adipophilin immunohistochemistry in the diagnosis of sebaceous carcinoma of the ocular adnexal region and to provide the guidelines for interpretation of this immunostain.
Retrospective, histopathologic case series.
A total of 25 patients with sebaceous carcinoma, 21 patients with basal cell carcinoma, 22 patients with conjunctival squamous cell carcinoma, 9 patients with cutaneous squamous cell carcinoma, and 5 patients with conjunctival mucoepidermoid carcinoma.
Immunohistochemical staining for adipophilin was performed on paraffin-embedded tissues and correlated with hematoxylin-eosin, periodic acid-Schiff (PAS), and mucicarmine-stained preparations. Immunostaining was quantified by light microscopy and with a computerized image analysis system of scanned images. Statistical analysis was performed to compare immunostaining patterns within the tumor categories by stage and grade, between the different neoplasms, and for correlation between light microscopy observations and computerized image analysis.
Localization of adipophilin immunostain, intensity of immunostaining, percent of immunoreactive cells, percentages of vacuolar staining and granular staining, and vacuole size.
Adipophilin expression was observed in 100% of sebaceous carcinomas, 100% of cutaneous squamous cell carcinomas, 95% of basal cell carcinomas, 73% of conjunctival squamous cell carcinomas, and 60% of mucoepidermoid carcinomas. Sebaceous carcinomas demonstrated significantly stronger adipophilin expression, a greater number of intracytoplasmic vacuoles, and larger vacuoles. The specificity and sensitivity of adipophilin immunostaining in the diagnosis of sebaceous carcinoma were both 100% when more than 5% of the staining occurred in vacuoles (<95% granular staining). The diagnostic sensitivity and specificity were 100% and 96%, respectively, when the staining was graded as moderately or strongly intense and were 92% and 85% when the vacuoles were greater than 1.5 μm in diameter.
Although upregulation of neoplastic steatogenesis is observed in both sebaceous and nonsebaceous carcinomas, the pattern and intensity of adipophilin immunostaining are helpful in distinguishing sebaceous carcinoma from other neoplasms with overlapping histology.
确定脂肪细胞素免疫组化在诊断眼附属器部位皮脂腺癌中的作用，并为该免疫染色的解释提供指导。
回顾性组织病理学病例系列。
共 25 例皮脂腺癌患者、21 例基底细胞癌患者、22 例结膜鳞状细胞癌患者、9 例皮肤鳞状细胞癌患者和 5 例结膜黏液表皮样癌患者。
对石蜡包埋组织进行脂肪细胞素免疫组织化学染色，并与苏木精-伊红、过碘酸-Schiff（PAS）和粘卡红染色切片进行相关性分析。通过光学显微镜和扫描图像的计算机图像分析系统对免疫染色进行定量分析。通过统计学分析比较肿瘤分期和分级、不同肿瘤之间以及光学显微镜观察与计算机图像分析之间的免疫染色模式。
脂肪细胞素免疫染色的定位、染色强度、免疫反应细胞的百分比、空泡染色和颗粒状染色的百分比以及空泡大小。
脂肪细胞素在 100%的皮脂腺癌、100%的皮肤鳞状细胞癌、95%的基底细胞癌、73%的结膜鳞状细胞癌和 60%的黏液表皮样癌中均有表达。皮脂腺癌表现出更强的脂肪细胞素表达、更多的细胞内空泡和更大的空泡。当空泡染色（<95%颗粒状染色）大于 5%时，脂肪细胞素免疫染色在诊断皮脂腺癌中的特异性和敏感性均为 100%。当染色分级为中度或强时，诊断敏感性和特异性分别为 100%和 96%，当空泡直径大于 1.5μm 时，诊断敏感性和特异性分别为 92%和 85%。
尽管肿瘤性脂肪生成的上调在皮脂腺癌和非皮脂腺癌中均有观察到，但脂肪细胞素免疫染色的模式和强度有助于将皮脂腺癌与具有重叠组织学特征的其他肿瘤区分开来。
