Kindblom L G, Jacobsen G K, Jacobsen M
Hum Pathol. 1982 Sep;13(9):834-40. doi: 10.1016/s0046-8177(82)80080-4.
The aim of this study was to localize alpha 1-antitrypsin, ferritin, and lysozyme by means of the indirect immunoperoxidase technique and to evaluate the significance of these antigens as markers of histiocytic differentiation in tumors of a supposed dual fibroblastic-histiocytic origin. The series comprised 31 malignant fibrous histiocytomas (MFH) of the pleomorphic, spindle cell, and myxoid types, four cutaneous fibrous histiocytomas, and four atypical fibroxanthomas, four dermatofibrosarcoma protuberans, and two osteoclastomas of bone. For comparison, 15 soft tissue sarcomas of various other types were examined. Of the MFHs of the pleomorphic type, 18 of 22 (82 per cent) were positively stained for alpha 1-antitrypsin and 12 of 22 (54 per cent) were positively stained for ferritin. Of the five MFHs of the spindle cell type, none was positively stained for alpha 1-antitrypsin, three were positive for ferritin, and one was positive for lysozyme. None of the myxoid variants (corresponding to grade I-II myxofibrosarcoma) was positively stained for either of the antigens. These results and the observations made on the cutaneous fibrous histiocytomas, atypical fibroxanthomas, dermatofibrosarcoma protuberans, and the various soft tissue sarcomas indicated that 1) alpha 1-antitrypsin is a valuable marker of histiocytic differentiation in both benign and malignant fibrous histiocytomas, 2) ferritin can be visualized in more than half of these fibroblastic-histiocytic tumors, and the presence of ferritin distinguishes the spindle cells of these tumors from fibroblasts of connective tissue and most fibrosarcomas, and 3) lysozyme, although a good marker of histiocytic differentiation in ordinary histiocytes and benign fibrous histiocytomas, is a poor marker of neoplastic histiocytes of malignant tumors. The results further support the concept that MFH is a tumor of a dual fibroblastic-histiocytic origin.
本研究的目的是通过间接免疫过氧化物酶技术对α1 -抗胰蛋白酶、铁蛋白和溶菌酶进行定位，并评估这些抗原作为假定具有双相纤维母细胞 - 组织细胞起源肿瘤中组织细胞分化标志物的意义。该系列包括31例多形性、梭形细胞和黏液样型恶性纤维组织细胞瘤（MFH）、4例皮肤纤维组织细胞瘤、4例非典型纤维黄色瘤、4例隆突性皮肤纤维肉瘤和2例骨巨细胞瘤。作为对照，检查了15例其他各种类型的软组织肉瘤。在多形性MFH中，22例中有18例（82%）α1 -抗胰蛋白酶染色阳性，22例中有12例（54%）铁蛋白染色阳性。在5例梭形细胞型MFH中，无α1 -抗胰蛋白酶染色阳性者，3例铁蛋白阳性，1例溶菌酶阳性。黏液样型（相当于I - II级黏液纤维肉瘤）均无这两种抗原染色阳性。这些结果以及对皮肤纤维组织细胞瘤、非典型纤维黄色瘤、隆突性皮肤纤维肉瘤和各种软组织肉瘤的观察表明：1）α1 -抗胰蛋白酶是良性和恶性纤维组织细胞瘤中组织细胞分化的有价值标志物；2）在这些纤维母细胞 - 组织细胞瘤中，半数以上可显示铁蛋白，铁蛋白的存在可将这些肿瘤的梭形细胞与结缔组织的成纤维细胞及大多数纤维肉瘤相区分；3）溶菌酶虽然是正常组织细胞和良性纤维组织细胞瘤中组织细胞分化的良好标志物，但在恶性肿瘤的肿瘤性组织细胞中却是不良标志物。这些结果进一步支持了MFH是具有双相纤维母细胞 - 组织细胞起源肿瘤的概念。
