Borrow L G, Norton A J
Histopathology Department, Imperial Cancer Research Fund/Royal College of Surgeons, University College London.
Cancer Surv. 1987;6(2):209-25.
Recently developed immunohistological techniques coupled with the advent of the monoclonal antibody era have revolutionized diagnostic tumour pathology. The search for a tumour specific marker has not been fulfilled; however, judicious use of panels of antibodies recognizing tissue differentiation antigens has enabled separation of morphologically indistinct tumours where this was not previously possible. This same approach has proved useful for identifying site of origin in small tumour biopsy specimens, in aspirates of malignant cells from body fluids and in micrometastases. Lymphoma phenotyping is the field where the greatest advances have been made. This is because of the diverse range of antibodies available in this area and the widespread cooperation in characterizing and clustering these antibodies that has occurred at the three international workshops on leucocyte antigens. Less dramatic, but nevertheless appreciable advances have been made in the field of solid tumours, using antibodies to differentiation products or organ specific products to identify the site of origin of a carcinoma or sarcoma. The identification of consistent production of aberrant differentiation products also provides a promising approach to tumour identification. The recognition of changed antigenic phenotype in preinvasive neoplastic cells offers a means of early, more objective, diagnostic assessment of these lesions.
最近开发的免疫组织学技术,再加上单克隆抗体时代的到来,彻底改变了肿瘤诊断病理学。寻找肿瘤特异性标志物的工作尚未完成;然而,明智地使用识别组织分化抗原的抗体组合,使得以前无法区分的形态学上难以辨别的肿瘤得以区分。同样的方法已被证明可用于识别小肿瘤活检标本、体液中恶性细胞抽吸物以及微转移灶的起源部位。淋巴瘤表型分析是取得最大进展的领域。这是因为该领域有各种各样的抗体,并且在关于白细胞抗原的三次国际研讨会上,在对这些抗体进行表征和聚类方面开展了广泛合作。在实体瘤领域也取得了不太显著但仍很可观的进展,利用针对分化产物或器官特异性产物的抗体来识别癌或肉瘤的起源部位。识别异常分化产物的持续产生也为肿瘤识别提供了一种有前景的方法。识别侵袭前肿瘤细胞中抗原表型的变化,为这些病变的早期、更客观的诊断评估提供了一种手段。