DeLellis R A, Tischler A S, Lee A K, Blount M, Wolfe H J
Am J Surg Pathol. 1983 Jan;7(1):29-37. doi: 10.1097/00000478-198301000-00003.
Leu-enkephalin, a potent, endogenous, opiate-like regulatory peptide, is present in a subpopulation of normal adrenal medullary cells and in a spectrum of proliferative lesions of adrenal and extra-adrenal chromaffin cell origin. The presence, extent, and intensity of leu-enkephalin-like immunoreactivity is variable in normal and pathological states. While areas of diffuse medullary hyperplasia consistently exhibited leu-enkephalin-like immunoreactivity, approximately 50% of hyperplastic medullary nodules, pheochromocytomas, and paragangliomas were positively stained. Tumors of neuroblastic origin, on the other hand, did not contain leu-enkephalin-like immunoreactivity. Variations in leu-enkephalin-like immunoreactivity may be related to aberrations of feedback mechanisms, multicentric origins of lesions from chromaffin cells with or without the capacity for leu-enkephalin synthesis, or to a variety of other mechanisms, including defective innervation of hyperplastic and neoplastic chromaffin cells. The results of these studies indicate that leu-enkephalin-like immunoreactivity is a useful tissue marker for the demonstration of chromaffin cell hyperplasia and neoplasia and may also prove to be an important clinical marker for the assessment of chromaffin cell hyperfunction.
亮氨酸脑啡肽是一种强效的内源性阿片样调节肽，存在于正常肾上腺髓质细胞的一个亚群以及一系列肾上腺和肾上腺外嗜铬细胞起源的增殖性病变中。在正常和病理状态下，亮氨酸脑啡肽样免疫反应性的存在、范围和强度各不相同。虽然弥漫性髓质增生区域始终表现出亮氨酸脑啡肽样免疫反应性，但约50%的增生性髓质结节、嗜铬细胞瘤和副神经节瘤呈阳性染色。另一方面，神经母细胞起源的肿瘤不含亮氨酸脑啡肽样免疫反应性。亮氨酸脑啡肽样免疫反应性的变化可能与反馈机制异常、嗜铬细胞病变的多中心起源（无论有无合成亮氨酸脑啡肽的能力）或多种其他机制有关，包括增生性和肿瘤性嗜铬细胞的神经支配缺陷。这些研究结果表明，亮氨酸脑啡肽样免疫反应性是显示嗜铬细胞增生和肿瘤形成的有用组织标志物，也可能被证明是评估嗜铬细胞功能亢进的重要临床标志物。
