Stead R H, Qizilbash A H, Kontozoglou T, Daya A D, Riddell R H
Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
Hum Pathol. 1988 Jan;19(1):32-40. doi: 10.1016/s0046-8177(88)80313-7.
An immunohistochemical study of 34 pleomorphic adenomas of the major salivary glands demonstrated phenotypic differences among the various morphologic regions in these tumors. The phenotypes expressed were comparable to those of normal salivary gland cells. In the normal glands, myoepithelial cells were immunoreactive for glial fibrillary acidic protein (GFAP), S-100 protein, and keratin; acinic cells exhibited strong, predominantly nuclear S-100 staining and weaker keratin staining; intercalated ducts had both cytoplasmic and nuclear S-100 positivity; and several epithelial antigens were observed throughout the ductal system. In the tumors, the presence of classic epithelial markers (including carcinoembryonic antigen, epithelial membrane antigen, secretory component, and keratin) in the luminal cells of ducts and the intense immunoreactivity with GFAP (with weaker keratin and S-100 staining) in periductal and stromal cells indicated distinct epithelial and myoepithelial differentiation. Solid epithelioid areas consisted phenotypically of intercalated duct/acinic cells and/or myoepithelial cells, the former exhibiting predominant nuclear S-100 positivity. The presence of GFAP-like immunoreactivity in normal myoepithelial cells strongly supports the extensive involvement of this cell in pleomorphic adenomas. The spectrum of phenotypes expressed adds weight to existing evidence for pleomorphism rather than a mixed origin of this tumor. The combination of keratin, S-100, and GFAP immunostaining is particularly useful in identifying the component cells in pleomorphic adenomas of the salivary glands.
一项对34例大唾液腺多形性腺瘤的免疫组织化学研究表明，这些肿瘤的不同形态学区域存在表型差异。所表达的表型与正常唾液腺细胞的表型相似。在正常腺体中，肌上皮细胞对胶质纤维酸性蛋白（GFAP）、S-100蛋白和角蛋白呈免疫反应；腺泡细胞显示出强烈的、主要为核内的S-100染色和较弱的角蛋白染色；闰管具有胞质和核内S-100阳性；并且在整个导管系统中观察到几种上皮抗原。在肿瘤中，导管腔内细胞中存在经典上皮标志物（包括癌胚抗原、上皮膜抗原、分泌成分和角蛋白），以及导管周围和间质细胞中与GFAP的强烈免疫反应（角蛋白和S-100染色较弱）表明了明显的上皮和肌上皮分化。实性上皮样区域在表型上由闰管/腺泡细胞和/或肌上皮细胞组成，前者显示出主要为核内的S-100阳性。正常肌上皮细胞中存在GFAP样免疫反应强烈支持该细胞在多形性腺瘤中的广泛参与。所表达的表型谱为现有的关于该肿瘤多形性而非混合起源的证据增加了分量。角蛋白、S-100和GFAP免疫染色的联合应用在识别唾液腺多形性腺瘤中的组成细胞方面特别有用。
