先天性牙龈瘤与颗粒细胞瘤：一项组织学和免疫组织化学研究
Congenital epulis and granular cell tumor: a histologic and immunohistochemical study.
作者信息
Kaiserling E, Ruck P, Xiao J C
机构信息
Institute of Pathology, University of Tübingen, Germany.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995 Dec;80(6):687-97. doi: 10.1016/s1079-2104(05)80253-7.
OBJECTIVES
Although it is now reasonably certain that granular cell tumors derive from Schwann cells, the histogenesis of congenital epulis, which is largely isomorphic with granular cell tumor, remains unclear. A study was undertaken to compare the immunophenotype of these tumors with particular emphasis on the expression of matrix proteins and macrophage markers because such information is not available in the literature.
STUDY DESIGN
Four granular cell tumors and two congenital epulis were immunostained with a panel of 29 antibodies. Two congenital epulis and one granular cell tumor were investigated by electron microscopy, the latter also by immunoelectron microscopy.
RESULTS
Many similarities in immunostaining were found, for example, both tumor types were CD68+, Ki-M1P+, lysozyme-, vimentin+, fibronectin+, laminin+, lectin PHAE+, and lectin WGA+. However, differences were also noted, for example, granular cell tumor was always S100 protein+, but only one congenital epulis case was reactive (weak reactivity after microwave treatment), and staining with the proliferation markers anti-proliferating cell nuclear antigen and MIB 1 was found only in congenital epulis. Both tumor types exhibited pericellular and diffuse cytoplasmic staining for fibronectin and laminin.
CONCLUSIONS
The hypothesis that congenital epulis and granular cell tumor would exhibit similar reactivity for macrophage markers was confirmed: both were reactive with anti-CD68 and Ki-M1P and nonreactive with MAC387, anti-lysozyme, and 3A5. Intracytoplasmic staining for fibronectin and laminin, which has not been described previously in these tumors, appears to be a characteristic feature common to both tumors. This finding suggests that there could be a disturbance of synthesis and secretion of extracellular matrix proteins or a derangement of their receptor systems. This theory could be supported by the finding of intracytoplasmic CD49e-positive material in two cases.
目的
尽管现在已基本确定颗粒细胞瘤起源于施万细胞，但与颗粒细胞瘤在很大程度上同形的先天性龈瘤的组织发生仍不清楚。开展了一项研究以比较这些肿瘤的免疫表型，特别着重于基质蛋白和巨噬细胞标志物的表达，因为文献中尚无此类信息。
研究设计
用一组29种抗体对4例颗粒细胞瘤和2例先天性龈瘤进行免疫染色。对2例先天性龈瘤和1例颗粒细胞瘤进行电子显微镜检查，后者还进行了免疫电子显微镜检查。
结果
发现免疫染色有许多相似之处，例如，两种肿瘤类型均CD68阳性、Ki-M1P阳性、溶菌酶阴性、波形蛋白阳性、纤连蛋白阳性、层粘连蛋白阳性、凝集素PHAE阳性和凝集素WGA阳性。然而，也注意到了差异，例如，颗粒细胞瘤总是S100蛋白阳性，但只有1例先天性龈瘤病例有反应（微波处理后反应较弱），并且增殖标志物抗增殖细胞核抗原和MIB 1染色仅在先天性龈瘤中发现。两种肿瘤类型的纤连蛋白和层粘连蛋白均呈现细胞周围和弥漫性细胞质染色。
结论
先天性龈瘤和颗粒细胞瘤对巨噬细胞标志物表现出相似反应性的假说得到证实：二者均与抗CD68和Ki-M1P反应，而与MAC387、抗溶菌酶和3A5无反应。纤连蛋白和层粘连蛋白的细胞质内染色在这些肿瘤中此前未被描述，似乎是两种肿瘤共有的特征性表现。这一发现提示细胞外基质蛋白的合成和分泌可能存在紊乱或其受体系统发生失调。这一理论可得到两例细胞质内CD49e阳性物质这一发现的支持。
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