Fraga M, García-Caballero T, Antúnez J, Couce M, Beiras A, Forteza J
Department of Anatomy and Forensic Sciences, General Hospital of Galicia-School of Medicine, University of Santiago, Spain.
Histol Histopathol. 1993 Jul;8(3):429-36.
There is no definite morphological distinction between phaeochromocytomas and paragangliomas. We, therefore, attempted to determine the universality and differential utility of a panel of tumour markers for diagnosis in formalin-fixed, paraffin-embedded specimens. Antibodies to neuron-specific enolase (NSE), chromogranin, synaptophysin, Leu-7, neurofilaments, cytokeratins, carcinoembryonic antigen (CEA), melanoma antigen HMB-45, S-100 protein and glial fibrillary acid protein (GFAP), were used on 11 phaeochromocytomas and 8 paragangliomas. NSE reactivity was detected in 10 phaeochromocytomas and in all paragangliomas. Chromogranin reactivity was found in all but two cases (one phaeochromocytoma and one paraganglioma). Synaptophysin reactivity was present in 10 phaeochromocytomas and in the 8 paragangliomas. Ten phaeochromocytomas stained for Leu-7, but none of the paragangliomas did. S-100-positive cells (sustentacular or type II cells) were found in 8 phaeochromocytomas and 7 paragangliomas. GFAP stained sustentacular cells of only one paraganglioma. Only in 5 phaeochromocytomas was there a focal reaction by neurofilaments. Cytokeratins, CEA and HMB-45 were never detected. We conclude that NSE, chromogranin, synaptophysin and S-100 protein are useful markers of both types of tumour, whereas GFAP staining is limited to a small number of these neoplasms. Leu-7 reactivity seems to favour diagnosis of phaeochromocytoma rather than paraganglioma, but further studies with larger series are needed to confirm this. Unlike previous reports, we did not find cytokeratin or HMB-45 immunostaining in any case.
嗜铬细胞瘤和副神经节瘤之间没有明确的形态学差异。因此，我们试图确定一组肿瘤标志物在福尔马林固定、石蜡包埋标本诊断中的通用性和鉴别效用。我们使用了针对神经元特异性烯醇化酶（NSE）、嗜铬粒蛋白、突触素、Leu-7、神经丝、细胞角蛋白、癌胚抗原（CEA）、黑色素瘤抗原HMB-45、S-100蛋白和胶质纤维酸性蛋白（GFAP）的抗体，对11例嗜铬细胞瘤和8例副神经节瘤进行检测。在10例嗜铬细胞瘤和所有副神经节瘤中检测到NSE反应性。除两例（1例嗜铬细胞瘤和1例副神经节瘤）外，所有病例均发现嗜铬粒蛋白反应性。10例嗜铬细胞瘤和8例副神经节瘤中存在突触素反应性。10例嗜铬细胞瘤Leu-7染色阳性，但副神经节瘤均未染色阳性。8例嗜铬细胞瘤和7例副神经节瘤中发现S-100阳性细胞（支持细胞或II型细胞）。GFAP仅对1例副神经节瘤的支持细胞染色。仅在5例嗜铬细胞瘤中发现神经丝有局灶性反应。从未检测到细胞角蛋白、CEA和HMB-45。我们得出结论，NSE、嗜铬粒蛋白、突触素和S-100蛋白是这两种肿瘤的有用标志物，而GFAP染色仅限于少数这些肿瘤。Leu-7反应性似乎有利于嗜铬细胞瘤而非副神经节瘤的诊断，但需要更大样本量的进一步研究来证实这一点。与之前的报告不同，我们在任何病例中均未发现细胞角蛋白或HMB-45免疫染色。
