Puts J J, Moesker O, Aldeweireldt J, Vooijs G P, Ramaekers F C
Department of Pathology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
Int J Gynecol Pathol. 1987;6(3):257-74. doi: 10.1097/00004347-198709000-00007.
Polyclonal antibodies to cytokeratins, vimentin, and desmin and monoclonal antibodies to vimentin and to individual cytokeratin polypeptides, specific for glandular epithelia (RGE 53) or kertinizing stratified squamous epithelia (RKSE 60), have been applied in gynecological tumors with simple or complex composition. In general, tumors with simple composition showed reaction patterns fitting their known epithelial or mesenchymal nature, i.e., cytokeratin positivity in epithelial tumors only, vimentin positivity in mesenchymal tumors, and expression of desmin and vimentin in muscle cell tumors. Rather frequently, coexpression of cytokeratins and vimentin was noted in endometrial adenocarcinomas. Tumors with complex composition, such as müllerian mesodermal mixed tumors (MMMTs), that may pose considerable problems in conventional histopathology revealed various reaction patterns, with either expression of only cytokeratins or coexpression of cytokeratins and vimentin in carcinomatous areas and expression of only vimentin in sarcomatous areas. However, in addition, some MMMTs contained cells that were also positive for desmin. Intermediate filament protein immunohistochemistry appeared to be helpful in establishing a diagnosis of MMMT and in characterizing the different tumor components, which may prove to be useful in the evaluation of gynecological treatment protocols.
针对细胞角蛋白、波形蛋白和平滑肌肌动蛋白的多克隆抗体，以及针对波形蛋白和个别细胞角蛋白多肽的单克隆抗体，对腺上皮（RGE 53）或角化复层鳞状上皮（RKSE 60）具有特异性，已应用于成分简单或复杂的妇科肿瘤。一般来说，成分简单的肿瘤表现出与其已知上皮或间充质性质相符的反应模式，即仅上皮肿瘤中细胞角蛋白呈阳性，间充质肿瘤中波形蛋白呈阳性，肌细胞肿瘤中平滑肌肌动蛋白和波形蛋白呈阳性。相当常见的是，子宫内膜腺癌中细胞角蛋白和波形蛋白共表达。成分复杂的肿瘤，如苗勒管中胚叶混合瘤（MMMTs），在传统组织病理学中可能会带来相当大的问题，其显示出各种反应模式，癌性区域要么仅细胞角蛋白表达，要么细胞角蛋白和波形蛋白共表达，肉瘤区域仅波形蛋白表达。然而，此外，一些MMMTs还含有对平滑肌肌动蛋白也呈阳性的细胞。中间丝蛋白免疫组织化学似乎有助于MMMT的诊断及不同肿瘤成分的特征描述，这可能在妇科治疗方案的评估中有用。
