Kuopio T, Ekfors T O, Nikkanen V, Nevalainen T J
Department of Pathology, University of Turku, Finland.
APMIS. 1995 Jan;103(1):69-78. doi: 10.1111/j.1699-0463.1995.tb01081.x.
Pancreatic acinar cell carcinoma is a rare neoplasm (comprising about 1% of pancreatic tumours). We studied three cases (61-year-old female; 42-year-old male; 57-year-old male), whose survival after diagnosis ranged from 1 year 2 months to 6 years 8 months. There were widespread metastases in each case. The tumours had acinar, trabecular and solid growth patterns. By immunohistochemistry, pancreatic acinar cell markers including carboxyl ester lipase, pancreatic secretory trypsin inhibitor and pancreatic phospholipase A2 (group I PLA2) gave a strong positive reaction in all three cases. By electron microscopy, zymogen granules were seen in the cytoplasm of the tumour cells. Immunostaining for prostate-specific antigen was positive in all three cases. Above-normal concentrations of pancreatic PLA2 were measured in the serum of one patient and the values decreased during chemotherapy concomitantly with the reduction in the size of the tumour mass. In conclusion, immunohistochemical demonstration of the secretory products of acinar cells including the new marker pancreatic PLA2 is useful in the differential diagnosis of pancreatic acinar cell carcinoma. Determination of the concentration of pancreatic group I PLA2 in serum may be helpful in the evaluation of therapy.
胰腺腺泡细胞癌是一种罕见的肿瘤（约占胰腺肿瘤的1%）。我们研究了3例患者（1例61岁女性、2例男性，分别为42岁和57岁），其诊断后的生存期为1年2个月至6年8个月。每例均有广泛转移。肿瘤具有腺泡、小梁和实性生长模式。免疫组化显示，包括羧基酯脂肪酶、胰腺分泌型胰蛋白酶抑制剂和胰腺磷脂酶A2（I型PLA2）在内的胰腺腺泡细胞标志物在所有3例中均呈强阳性反应。电镜检查可见肿瘤细胞胞质内有酶原颗粒。3例患者前列腺特异性抗原免疫染色均为阳性。1例患者血清中检测到高于正常浓度的胰腺PLA2，化疗期间随着肿瘤肿块缩小，该值下降。总之，包括新标志物胰腺PLA2在内的腺泡细胞分泌产物的免疫组化显示，对胰腺腺泡细胞癌的鉴别诊断有用。测定血清中I型胰腺PLA2的浓度可能有助于评估治疗效果。
