Sirgi K E, Wick M R, Swanson P E
Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University School of Medicine, St. Louis, Missouri 63110.
Am J Surg Pathol. 1993 Feb;17(2):179-85. doi: 10.1097/00000478-199302000-00009.
The accurate immunohistochemical diagnosis of epithelioid angiosarcoma--as distinct from carcinomas and other epithelioid neoplasms--is hindered by the lack of endothelial-selective reagents that are both sensitive and specific. To evaluate the potential utility of an "epithelial-specific" and an "endothelial-selective" monoclonal antibody in this differential diagnosis, B72.3 [anti-TAG 72 (tumor-associated glycoprotein-72)] and My 10 [anti-CD34 (the hematopoietic progenitor cell antigen)] were applied to 14 examples of angiosarcoma (seven with an epithelioid phenotype), nine epithelioid hemangioendotheliomas, and eight capillary hemangiomas, together with antibodies to factor VIII-related antigen (F8rag) and cytokeratin (CK), and the lectin Ulex europaeus I (UEA). The results of these analyses were compared with stains fro B72.3, CD34, and Ck in a variety of other epithelioid soft tissue neoplasms, including four epithelioid sarcomas, three epithelioid malignant peripheral nerve sheath tumors, three alveolar soft part sarcomas, four clear cell sarcomas (malignant melanomas of soft parts), five malignant fibrous histiocytomas, and seven epithelioid leiomyosarcomas. The endothelial phenotype of each vascular tumor was supported by staining for either F8rag or UEA in all examples. Only angiosarcomas were reactive with B72.3, including five of seven epithelioid variants. None was positive for cytokeratin. Four epithelioid angiosarcomas were also reactive for CD34, but so were the majority of epithelioid leiomyosarcomas and at least one example each of all other epithelioid soft tissue tumors, except alveolar soft part sarcoma. In contrast, none of the latter tumor types was reactive with B72.3. These data indicate that anti-CD34 is not specific for endothelial tumors, whereas B72.3 reactivity is selective for epithelioid angiosarcomas. Despite published reports to the contrary, no tumor in this series was reactive for cytokeratin. An immunohistochemical panel that includes antibodies to both cytokeratin and B72.3, in addition to other lineage-selective mesenchymal markers, is useful in the diagnostic recognition of epithelioid soft tissue neoplasms.
上皮样血管肉瘤的准确免疫组化诊断——与癌和其他上皮样肿瘤相区别——因缺乏既敏感又特异的内皮细胞选择性试剂而受到阻碍。为了评估一种“上皮特异性”和一种“内皮细胞选择性”单克隆抗体在这种鉴别诊断中的潜在效用，将B72.3 [抗TAG 72（肿瘤相关糖蛋白-72）]和My 10 [抗CD34（造血祖细胞抗原）]应用于14例血管肉瘤（7例具有上皮样表型）、9例上皮样血管内皮瘤和8例毛细血管瘤，同时使用抗VIII因子相关抗原（F8rag）、细胞角蛋白（CK）抗体以及凝集素欧洲荆豆I（UEA）。将这些分析结果与B72.3、CD34和CK在多种其他上皮样软组织肿瘤中的染色结果进行比较，这些肿瘤包括4例上皮样肉瘤、3例上皮样恶性外周神经鞘瘤、3例肺泡软组织肉瘤、4例透明细胞肉瘤（软组织恶性黑色素瘤）、5例恶性纤维组织细胞瘤和7例上皮样平滑肌肉瘤。在所有病例中，每种血管肿瘤的内皮细胞表型均通过F8rag或UEA染色得到支持。只有血管肉瘤对B72.3有反应，包括7例上皮样变体中的5例。无一例对细胞角蛋白呈阳性。4例上皮样血管肉瘤对CD34也有反应，但大多数上皮样平滑肌肉瘤以及除肺泡软组织肉瘤外的所有其他上皮样软组织肿瘤中的至少1例也呈阳性。相比之下，后一种肿瘤类型均不对B72.3产生反应。这些数据表明抗CD34对内皮肿瘤不具有特异性，而B72.3反应性对上皮样血管肉瘤具有选择性。尽管有相反的报道，但本系列中没有肿瘤对细胞角蛋白产生反应。除其他谱系选择性间充质标记物外，包含细胞角蛋白和B72.3抗体的免疫组化检测组合在诊断识别上皮样软组织肿瘤方面很有用。
