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犬胰腺神经内分泌肿瘤是否类似于人类胰腺神经内分泌肿瘤?一项比较形态学和免疫组织化学研究。

Do Canine Pancreatic Neuroendocrine Neoplasms Resemble Human Pancreatic Neuroendocrine Tumours? A Comparative Morphological and Immunohistochemical Investigation.

机构信息

Department of Pathology, LABOKLIN GmbH & Co.KG, Bad Kissingen, Germany.

Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany.

出版信息

J Comp Pathol. 2020 Nov;181:73-85. doi: 10.1016/j.jcpa.2020.10.001. Epub 2020 Nov 17.

Abstract

Although canine pancreatic neuroendocrine neoplasms (PanNENs) have been proposed as a model for the counterpart human neoplasms, the type or grade of human PanNEN that they resemble is unclear. PanNENs in animals are classified as adenoma or carcinoma, whereas in humans they are classified as pancreatic neuroendocrine tumour (PanNET) if well-differentiated, or as pancreatic neuroendocrine carcinoma (PanNEC) if poorly differentiated. We evaluated 16 canine primary PanNENs and two metastases histologically and immunohistochemically, and graded them using the animal and human grading systems. All neoplasms had local or vascular invasion and were classified as pancreatic islet cell carcinomas according to the current WHO classification. The Ki-67 index was low in all cases (0.01-1.50%). All had cytoplasmic expression of synaptophysin and insulin but were immunonegative for glucagon, confirming a functional diagnosis of canine insulinoma. Membranous expression of SSTR2A and nuclear expression of ATRX, but no p53 expression, was found in all neoplasms. One primary tumour was diagnosed as a mixed neuroendocrine-non-neuroendocrine neoplasm, which is the first report of this neoplasm in dogs. The other 15 primary tumours and both metastatic tumours were graded as PanNET G1, according to the human WHO classification. We conclude that canine PanNENs share well-differentiated histomorphology, SSTR2A expression and absence of nuclear p53 immunolabelling with human PanNETs G1. However, they differ in ATRX gene expression and functionality, and seem to have a worse prognosis than human PanNETs G1, although their generally low Ki-67 index precludes more precise assessment of prognosis. Membranous SSTR2A expression renders canine PanNENs potentially amenable to treatment with somatostatin analogues or SSTR targeted in-vivo imaging methods.

摘要

虽然犬类胰腺神经内分泌肿瘤(PanNENs)已被提议作为对应人类肿瘤的模型,但它们类似于哪种类型或等级的人类 PanNEN 尚不清楚。动物的 PanNEN 分为腺瘤或癌,而在人类中,如果分化良好,则分类为胰腺神经内分泌肿瘤(PanNET),如果分化不良,则分类为胰腺神经内分泌癌(PanNEC)。我们对 16 例犬原发性 PanNEN 和 2 例转移灶进行了组织学和免疫组织化学评估,并使用动物和人类分级系统对其进行了分级。所有肿瘤均有局部或血管侵犯,并根据现行的世界卫生组织分类被归类为胰岛细胞癌。所有病例的 Ki-67 指数均较低(0.01-1.50%)。所有肿瘤均表达突触素和胰岛素的细胞质,但免疫组化不表达胰高血糖素,证实了犬胰岛素瘤的功能诊断。所有肿瘤均表达膜型 SSTR2A 和核型 ATRX,但均不表达 p53。一个原发性肿瘤被诊断为混合性神经内分泌-非神经内分泌肿瘤,这是犬中首例此类肿瘤的报告。根据人类 WHO 分类,其他 15 个原发性肿瘤和 2 个转移瘤均被归类为 PanNET G1。我们得出结论,犬类 PanNEN 与人类 PanNET G1 具有相似的高分化组织形态学、SSTR2A 表达和核型 p53 免疫标记缺失。然而,它们在 ATRX 基因表达和功能上存在差异,并且似乎比人类 PanNET G1 的预后更差,尽管它们普遍较低的 Ki-67 指数使对预后进行更精确的评估变得不可能。膜型 SSTR2A 表达使犬类 PanNEN 可能适合使用生长抑素类似物或 SSTR 靶向的体内成像方法进行治疗。

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