Ellis G L, Langloss J M, Heffner D K, Hyams V J
Am J Surg Pathol. 1987 May;11(5):335-42. doi: 10.1097/00000478-198705000-00001.
Immunohistochemical analysis of 21 prototypic mucosal spindle-cell carcinomas of the aerodigestive tract was performed at the Armed Forces Institute of Pathology (AFIP) to establish the usefulness of selected immunohistochemical markers in distinguishing spindle-cell carcinoma from other mucosal spindle-cell neoplasms. Immunoreactive keratin could be demonstrated in only 13/21 (62%) of cases. Coexpression of keratin and vimentin was demonstrated in 10/17 (59%) of the tumors evaluated for both of these intermediate filaments. All spindle-cell carcinomas lacked S100 protein, which is an immunoreactivity we would expect to find in spindle-cell malignant melanoma, one of the principal considerations in a differential diagnosis. Both alpha-1-antitrypsin (AAT) and alpha-1-antichymotrypsin (ACT) were demonstrated in the tumor cells in all cases. However, albumin had a similar distribution in the tumors, which suggested that passive uptake was a serious confusing factor. The results of this study indicate that AAT and ACT are unreliable markers for distinguishing spindle-cell carcinomas from malignant fibrous histiocytomas.
美国武装部队病理研究所（AFIP）对21例原型的消化道黏膜梭形细胞癌进行了免疫组织化学分析，以确定所选免疫组织化学标志物在鉴别梭形细胞癌与其他黏膜梭形细胞肿瘤中的作用。仅在13/21（62%）的病例中可检测到免疫反应性角蛋白。在针对这两种中间丝进行评估的肿瘤中，10/17（59%）的肿瘤显示角蛋白和波形蛋白共表达。所有梭形细胞癌均缺乏S100蛋白，而在梭形细胞恶性黑色素瘤中可预期出现这种免疫反应性，梭形细胞恶性黑色素瘤是鉴别诊断中的主要考虑因素之一。在所有病例的肿瘤细胞中均证实了α1抗胰蛋白酶（AAT）和α1抗糜蛋白酶（ACT）的存在。然而，白蛋白在肿瘤中的分布相似，这表明被动摄取是一个严重的混淆因素。本研究结果表明，AAT和ACT是区分梭形细胞癌与恶性纤维组织细胞瘤的不可靠标志物。
