Hasegawa T, Seki K, Yang P, Hirose T, Hizawa K, Wada T, Wakabayashi J
First Department of Pathology, University of Tokushima School of Medicine, Japan.
Hum Pathol. 1995 Aug;26(8):838-45. doi: 10.1016/0046-8177(95)90004-7.
To assess the histological grade in benign and malignant cartilage tumors of bone by more objective methods, we examined the differentiation and proliferative activity of tumor cells in six enchondromas, five chondroblastomas, and 13 chondrosarcomas immunohistochemically. A variable number of cells in all tumors showed S-100 protein and vimentin immunoreactivity. In fully differentiated cartilage of enchondromas and low grade chondrosarcomas, tenascin, which is an extracellular matrix glycoprotein, was present in small amounts or absent but was increased at the periphery of tumor lobules and even in the matrix throughout the high grade chondrosarcomas. Higher rate and intensity of proliferating cell nuclear antigen (PCNA) reactivity were found in chondrosarcomas, especially in spindle-shaped cells of high grade tumors, than in enchondromas. The distribution of PCNA-positive cells almost corresponded to the regions with tenascin reactivity. One tumor of high grade chondrosarcoma showed p53 protein immunoreactivity. Aberrant expression of cytokeratin was observed in four chondroblastomas. The expression of desmin was identified in relatively large proportions of enchondromas and chondrosarcomas, regardless of their benign or malignant nature and histological grade. Smooth muscle or muscle-specific actins also were present in a smaller number of tumors. Based on these findings, it is concluded that unusual staining characteristics were present, in addition to those of a chondroblastic nature, in the cartilage tumors of bone. Tenascin and PCNA positivity of various degrees in all chondroblastomas may suggest that they are chondrogenic tumors having a relatively high proliferative activity, albeit their benign clinical course. Proliferative activity of tumor cells in enchondromas and chondrosarcomas correlated well with their histological grade. Tenascin may play a role in promoting tumor cell proliferation of cartilagenous neoplasms and, on the other hand, the alterations of extracellular matrix involving tenascin synthesis seem to be a result of tumor development.
为了通过更客观的方法评估骨的良性和恶性软骨肿瘤的组织学分级，我们采用免疫组织化学方法检测了6例内生软骨瘤、5例软骨母细胞瘤和13例软骨肉瘤中肿瘤细胞的分化和增殖活性。所有肿瘤中均有数量不等的细胞显示S-100蛋白和波形蛋白免疫反应性。在内生软骨瘤和低级别软骨肉瘤的完全分化软骨中，细胞外基质糖蛋白腱生蛋白含量少或不存在，但在肿瘤小叶周边甚至在高级别软骨肉瘤的整个基质中增加。与内生软骨瘤相比，软骨肉瘤中增殖细胞核抗原（PCNA）反应性的发生率和强度更高，尤其是在高级别肿瘤的梭形细胞中。PCNA阳性细胞的分布几乎与腱生蛋白反应性区域相对应。1例高级别软骨肉瘤显示p53蛋白免疫反应性。在4例软骨母细胞瘤中观察到细胞角蛋白的异常表达。无论其良恶性及组织学分级如何，在相当比例的内生软骨瘤和软骨肉瘤中均鉴定出结蛋白的表达。少数肿瘤中也存在平滑肌或肌肉特异性肌动蛋白。基于这些发现，得出结论：除了具有成软骨细胞性质的特征外，骨软骨肿瘤还存在异常的染色特征。所有软骨母细胞瘤中不同程度的腱生蛋白和PCNA阳性可能表明它们是具有相对较高增殖活性的软骨源性肿瘤，尽管其临床过程为良性。内生软骨瘤和软骨肉瘤中肿瘤细胞的增殖活性与其组织学分级密切相关。腱生蛋白可能在促进软骨肿瘤细胞增殖中起作用，另一方面，涉及腱生蛋白合成的细胞外基质改变似乎是肿瘤发展的结果。
