Hu Y, Gao Y, Zhang X
Department of Pathology, West China University of Medical Sciences, Chengdu.
Zhonghua Bing Li Xue Za Zhi. 1996 Jun;25(3):142-4.
In order to investigate the clinicopathological and immunohistochemical features of chordomas, 34 chordomas, with 5 chondrosarcomas for comparison, were studied by clinicopathological and immunohistochemical methods.
Based on the presence or absence of cartilaginous areas, chordomas are classified into two subtypes: chondroid chordoma (14 cases) and classic chordoma (20 cases). Chondroid chordoma occurred in a younger age group (mean age 40.9 years) than classic chordoma (mean age 51.1 years). 7/14 (50%) of chondroid chordomas occurred in the sacrococcygeal region, 4/ 14 (28.6%) occurred in the spheno-occipital region. Immunohistochemical staining showed that all chordomas were positive for cytokeratin, and 16 (47.1%) chordomas were also positive for EMA. In contrast, 5 chondrosarcomas were immunonegative for both cytokeratin and EMA. Vimentin and S-100 protein were positive in the majority of chordomas (29 & 24 respectively) and in the 5 chondrosarcomas. The present study confirms the dual features of chordoma-epithelial and mesenchymal, and also the utility of immunohistochemical staining in the differential diagnosis of chordoma and chondrosarcoma. The pathologic diagnosis of chondroid chordoma and other issues were also discussed in the study.
为了研究脊索瘤的临床病理及免疫组化特征,采用临床病理及免疫组化方法对34例脊索瘤及5例软骨肉瘤进行了研究,后者作为对照。
根据有无软骨区域,脊索瘤分为两个亚型:软骨样脊索瘤(14例)和经典型脊索瘤(20例)。软骨样脊索瘤发病年龄组较年轻(平均年龄40.9岁),而经典型脊索瘤平均年龄为51.1岁。14例软骨样脊索瘤中7例(50%)发生于骶尾部,4例(28.6%)发生于蝶枕部。免疫组化染色显示,所有脊索瘤细胞角蛋白均呈阳性,16例(47.1%)脊索瘤上皮膜抗原(EMA)也呈阳性。相比之下,5例软骨肉瘤细胞角蛋白和EMA均呈免疫阴性。波形蛋白和S-100蛋白在大多数脊索瘤中呈阳性(分别为29例和24例),在5例软骨肉瘤中也呈阳性。本研究证实了脊索瘤上皮和间叶的双重特征,以及免疫组化染色在脊索瘤和软骨肉瘤鉴别诊断中的作用。本研究还讨论了软骨样脊索瘤的病理诊断及其他问题。