Beham A, Wirnsberger G, Schmid C
Wien Klin Wochenschr. 1986 Sep 26;98(18):617-22.
Malignant fibrous histiocytomas (MFH) belong to the most frequent soft tissue tumours in adults and have to be discriminated from other tumours with similar morphology. Various tumour markers aid the differential diagnosis. Twenty cases of MFH were studied immunohistochemically using antibodies to vimentin, TPA, desmin, lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin, S-100 protein, neurone-specific enolase (NSE), laminin, fibronectin and ferritin. Vimentin and lysozyme were found in the tumour cells of all, alpha 1-antitrypsin of 18, alpha 1-antichymotrypsin of 19, fibronectin of 16 and ferritin of 12 cases. Antibodies of TPA, desmin, S-100 protein, NSE and laminin did not reveal positive immunoreactivity. Exclusion of spindle-cell carcinoma can be made by positive vimentin and negative TPA reactivity, of melanoma by negative S-100 reactivity, and of leio- and rhabdomyosarcoma by lack of desmin immunoreactivity. Schwannomas contain S-100 protein, but lack lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin and fibronectin. Pleomorphic liposarcomas cannot be distinguished from MFH on the basis of immunohistochemical staining. Vimentin, alpha 1-antitrypsin, alpha 1-antichymotrypsin and fibronectin can, therefore, be regarded as useful markers in the differential diagnosis of MFH.
恶性纤维组织细胞瘤(MFH)是成人中最常见的软组织肿瘤之一,必须与其他形态相似的肿瘤相鉴别。多种肿瘤标志物有助于鉴别诊断。我们使用抗波形蛋白、组织多肽抗原(TPA)、结蛋白、溶菌酶、α1-抗胰蛋白酶、α1-抗糜蛋白酶、S-100蛋白、神经元特异性烯醇化酶(NSE)、层粘连蛋白、纤连蛋白和铁蛋白的抗体,对20例恶性纤维组织细胞瘤进行了免疫组织化学研究。所有病例的肿瘤细胞中均发现波形蛋白和溶菌酶,18例中有α1-抗胰蛋白酶,19例中有α1-抗糜蛋白酶,16例中有纤连蛋白,12例中有铁蛋白。TPA、结蛋白、S-100蛋白、NSE和层粘连蛋白的抗体未显示阳性免疫反应性。波形蛋白阳性且TPA反应性阴性可排除梭形细胞癌,S-100反应性阴性可排除黑色素瘤,结蛋白免疫反应性缺乏可排除平滑肌肉瘤和横纹肌肉瘤。神经鞘瘤含有S-100蛋白,但缺乏溶菌酶、α1-抗胰蛋白酶、α1-抗糜蛋白酶和纤连蛋白。多形性脂肪肉瘤在免疫组织化学染色的基础上无法与恶性纤维组织细胞瘤区分开来。因此,波形蛋白、α1-抗胰蛋白酶、α1-抗糜蛋白酶和纤连蛋白可被视为恶性纤维组织细胞瘤鉴别诊断中的有用标志物。