Fanburg J C, Rosenberg A E, Weaver D L, Leslie K O, Mann K G, Taatjes D J, Tracy R P
Department of Soft Tissue Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Am J Clin Pathol. 1997 Oct;108(4):464-73. doi: 10.1093/ajcp/108.4.464.
Osteosarcomas (OSAs) can be difficult to distinguish histologically from tumors with significantly different biologic potentials and treatment protocols. The correct diagnosis of OSA relies on identification of malignant osteoblasts that are capable of producing neoplastic bone. To determine the use of immunohistochemistry for the diagnosis of OSA, 106 tumors from the Massachusetts General Hospital and the University of Vermont were immunostained with monoclonal antiosteocalcin (OC) and antiosteonectin (ON) antibodies. They included 42 OSAs, 25 non-bone-forming sarcomas, 24 other malignant tumors including lymphomas, carcinomas, and melanomas, and 15 benign bone tumors. Cytoplasmic staining with OC showed 70% sensitivity and 100% specificity, while staining with ON showed 90% sensitivity and 54% specificity for bone-forming tumors, consistently staining cell types other than osteoblasts. Of the OSAs, 83% demonstrated matrix staining with one or both antibodies, whereas dense collagen was negative for both antibodies in all tumors. We conclude that tumor cell cytoplasmic staining with monoclonal OC may be helpful in distinguishing OSAs from other malignancies, and staining of extracellular matrix for OC and ON antibodies concurrently may help distinguish bone matrix from dense collagen.
骨肉瘤（OSA）在组织学上可能难以与具有显著不同生物学潜能和治疗方案的肿瘤相区分。OSA的正确诊断依赖于识别能够产生肿瘤性骨的恶性成骨细胞。为了确定免疫组织化学在OSA诊断中的应用，对来自麻省总医院和佛蒙特大学的106个肿瘤进行了单克隆抗骨钙素（OC）和抗骨连接蛋白（ON）抗体免疫染色。其中包括42例骨肉瘤、25例非骨形成性肉瘤、24例其他恶性肿瘤（包括淋巴瘤、癌和黑色素瘤）以及15例良性骨肿瘤。OC的细胞质染色显示敏感性为70%，特异性为100%，而ON染色对骨形成性肿瘤显示敏感性为90%，特异性为54%，始终对成骨细胞以外的细胞类型染色。在骨肉瘤中，83%的肿瘤用一种或两种抗体显示基质染色，而在所有肿瘤中致密胶原对两种抗体均为阴性。我们得出结论，肿瘤细胞用单克隆OC进行细胞质染色可能有助于将骨肉瘤与其他恶性肿瘤区分开来，同时对OC和ON抗体进行细胞外基质染色可能有助于将骨基质与致密胶原区分开来。
