Linnoila R I, Lack E E, Steinberg S M, Keiser H R
National Cancer Institute, Bethesda, Maryland.
Hum Pathol. 1988 Jan;19(1):41-50. doi: 10.1016/s0046-8177(88)80314-9.
Paraffin-embedded sections of 99 human adrenal and extraadrenal paragangliomas were analyzed by the indirect immunoperoxidase technique for the presence of neuron-specific enolase (NSE) and 10 neuropeptides. Each showed diffuse staining for NSE. Most tumors were positive for [Leu5]-enkephalin (76 per cent), [Met5]-enkephalin (75 per cent), somatostatin (67 per cent), and pancreatic polypeptide (51 per cent), followed by vasoactive intestinal polypeptide (VIP) (43 per cent), substance P (31 per cent), ACTH (28 per cent), calcitonin (23 per cent), bombesin (15 per cent), and neurotensin (12 per cent). The neuropeptides paralleled to a large extent those normally found in the sympathetic nervous system. Clinically malignant paragangliomas (n = 25) with proven regional or distant metastases expressed considerably fewer neuropeptides, although the spectrum of those seen remained similar. Malignant paragangliomas contained an average of two neuropeptides per tumor, in contrast to five for the benign tumors (P less than 0.05). Logistic regression analysis of staining results revealed that the paucity of enkephalins, somatostatin, pancreatic polypeptide, and VIP along with the patient's sex was predictive of clinical malignancy. Our results show a definite relationship between expression of neuropeptides and the biologic behavior of these paragangliomas.
采用间接免疫过氧化物酶技术，对99例人肾上腺及肾上腺外副神经节瘤的石蜡包埋切片进行分析，检测神经元特异性烯醇化酶（NSE）和10种神经肽的表达情况。每例标本NSE均呈弥漫性染色。多数肿瘤[亮氨酸5] - 脑啡肽（76%）、[甲硫氨酸5] - 脑啡肽（75%）、生长抑素（67%）和胰多肽（51%）呈阳性，其次为血管活性肠肽（VIP）（43%）、P物质（31%）、促肾上腺皮质激素（ACTH）（28%）、降钙素（23%）、蛙皮素（15%）和神经降压素（12%）。这些神经肽在很大程度上与交感神经系统中正常存在的神经肽相似。经证实有区域或远处转移的临床恶性副神经节瘤（n = 25）表达的神经肽明显较少，尽管所见神经肽的种类仍相似。恶性副神经节瘤平均每个肿瘤含有两种神经肽，而良性肿瘤为五种（P < 0.05）。对染色结果进行逻辑回归分析显示，脑啡肽、生长抑素、胰多肽和VIP的缺乏以及患者性别可预测临床恶性程度。我们的结果表明神经肽表达与这些副神经节瘤的生物学行为之间存在明确关系。
