Loda M, Lipman J, Cukor B, Bur M, Kwan P, DeLellis R A
Department of Pathology, Deaconess Hospital Boston, MA 02215.
Hum Pathol. 1994 Oct;25(10):1050-6. doi: 10.1016/0046-8177(94)90064-7.
Samples of normal, hyperplastic, and neoplastic parathyroid tissues were analyzed for proliferative activity to determine (1) whether a higher number of proliferating cells were detectable in adenoma and hyperplasia versus normal tissues; (2) whether there was a difference in the number of proliferating cells in adenoma versus hyperplasia; and (3) whether there was a relationship between nodularity and proliferative rate in both adenoma and hyperplasia. Formalin-fixed, paraffin-embedded tissue from 21 patients with parathyroid adenoma and 10 patients with hyperplasia (two primary, six secondary, and two tertiary) was analyzed by immunohistochemistry with the monoclonal antibody PC10 to proliferating cell nuclear antigen (PCNA) and, in a subset of cases, with Ki-67 (MIB 1) as markers of cell proliferation. The results were that (1) no proliferating cells were found in normal glands or residual rim of "suppressed" parathyroid tissue; (2) the most intense proliferative activity was confined to nodular areas in both adenomas (57% nodular) and hyperplasias (80% nodular); (3) when fields of highest number of labeled nuclei were chosen, PCNA counts were higher in adenomas than in hyperplasia in both nodular and diffuse areas (P < .05); and (4) the number of nuclei immunoreactive for Ki-67 (MIB-1) was consistently and proportionally lower (range, 13% to 45%; mean, 32%) than the number of those immunoreactive for PCNA, although the nodular pattern was maintained. These findings demonstrate that nodules within parathyroid adenomas and hyperplasias contain subpopulations of cells with a consistently higher proliferative rate than nonnodular areas. Cells within these nodules may be more likely to develop genetic abnormalities that have been observed in hyperplastic and neoplastic parathyroid tissues.
对正常、增生和肿瘤性甲状旁腺组织样本进行增殖活性分析，以确定：(1) 与正常组织相比，腺瘤和增生组织中是否可检测到更多的增殖细胞；(2) 腺瘤与增生组织中增殖细胞数量是否存在差异；以及 (3) 腺瘤和增生组织中结节性与增殖率之间是否存在关系。采用针对增殖细胞核抗原 (PCNA) 的单克隆抗体 PC10，对 21 例甲状旁腺腺瘤患者和 10 例增生患者（2 例原发性、6 例继发性和 2 例三发性）的福尔马林固定、石蜡包埋组织进行免疫组织化学分析，并在部分病例中使用 Ki- 67 (MIB 1) 作为细胞增殖标记物。结果显示：(1) 在正常腺体或“受抑制”甲状旁腺组织的残留边缘未发现增殖细胞；(2) 最强烈的增殖活性局限于腺瘤（57% 为结节性）和增生组织（80% 为结节性）的结节区域；(3) 当选择标记核数量最多的视野时，腺瘤中 PCNA 计数在结节性和弥漫性区域均高于增生组织（P < .05）；(4) 对 Ki-67 (MIB-1) 免疫反应阳性的核数量始终且成比例地低于对 PCNA 免疫反应阳性的核数量（范围为 13% 至 45%；平均值为 32%），尽管结节模式得以维持。这些发现表明，甲状旁腺腺瘤和增生组织内的结节含有增殖率始终高于非结节区域的细胞亚群。这些结节内的细胞可能更易发生在增生性和肿瘤性甲状旁腺组织中观察到的基因异常。
