Suster S, Fisher C, Moran C A
Arkadi M. Rywlin, Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center and University of Miami School of Medicine, Miami Beach, Florida 33140, USA.
Am J Surg Pathol. 1998 Jul;22(7):863-72. doi: 10.1097/00000478-199807000-00008.
An immunohistochemical study to determine the pattern of immunoreactivity for bcl-2 oncoprotein was performed in 380 spindle cell tumors of soft tissue, skin, serosal surfaces, and gastrointestinal tract. The cases studied included examples of benign, reactive spindle cell proliferations to benign and malignant spindle cell neoplasms, including nodular fasciitis (10), fibromatosis (5), dermatofibroma (10), dermatofibrosarcoma protuberans (18), Kaposi's sarcoma (15), spindle cell lipomatous tumors (24), benign and malignant smooth muscle tumors (35), neural/peripheral nerve sheath neoplasms (53), synovial sarcomas (70) solitary fibrous tumors of serosal surfaces and other sites (56), gastrointestinal stromal tumors (GIST) (47), and malignant undifferentiated fibroblastic spindle cell proliferations of soft tissue (37 cases). The results of bcl-2 staining was additionally correlated with CD34 immunoreactivity. Bcl-2 was uniformly negative in all cases of nodular fasciitis, fibromatosis, and dermatofibroma, as well as in benign and malignant smooth muscle proliferations. Strong positivity for bcl-2 was observed in all cases of spindle cell lipoma, dendritic fibromyxolipoma, Kaposi's sarcoma, solitary fibrous tumors, gastrointestinal stromal tumors, and in the spindle cell component of synovial sarcoma. With the exception of the last, there appeared to be a close correlation between the expression of bcl-2 and CD34 in these tumors. Strong bcl-2 positivity also was found, at least focally, in approximately one third of benign and malignant peripheral nerve sheath tumors, particularly in the better-differentiated (Antoni type A) areas. Sarcomas of fibroblastic type, including low-grade myxofibrosarcoma, malignant fibrous histiocytoma, and fibrosarcoma, showed variable expression of bcl-2 in the tumor cells. Our results appear to indicate that bcl-2 may have a wide distribution among benign and malignant spindle cell neoplasms. Strong expression of this marker in some of these conditions, particularly solitary fibrous tumor, gastrointestinal stromal tumors, and synovial sarcoma, may be of aid for differential diagnosis.
进行了一项免疫组织化学研究，以确定bcl-2癌蛋白的免疫反应模式，该研究针对380例软组织、皮肤、浆膜表面和胃肠道的梭形细胞肿瘤展开。所研究的病例包括良性、对良性和恶性梭形细胞肿瘤的反应性梭形细胞增殖，其中有结节性筋膜炎（10例）、纤维瘤病（5例）、皮肤纤维瘤（10例）、隆突性皮肤纤维肉瘤（18例）、卡波西肉瘤（15例）、梭形细胞脂肪瘤样肿瘤（24例）、良性和恶性平滑肌肿瘤（35例）、神经/外周神经鞘肿瘤（53例）、滑膜肉瘤（70例）、浆膜表面及其他部位的孤立性纤维瘤（56例）、胃肠道间质瘤（GIST）（47例）以及软组织恶性未分化纤维母细胞梭形细胞增殖（37例）。此外，还将bcl-2染色结果与CD34免疫反应性进行了相关性分析。在所有结节性筋膜炎、纤维瘤病和皮肤纤维瘤病例以及良性和恶性平滑肌增殖病例中，bcl-2均呈均匀阴性。在所有梭形细胞脂肪瘤、树突状纤维黏液脂肪瘤、卡波西肉瘤、孤立性纤维瘤、胃肠道间质瘤以及滑膜肉瘤的梭形细胞成分病例中，均观察到bcl-2呈强阳性。除最后一种情况外，在这些肿瘤中，bcl-2的表达与CD34之间似乎存在密切相关性。在大约三分之一的良性和恶性外周神经鞘肿瘤中，至少局部发现bcl-2呈强阳性，尤其在分化较好（Antoni A型）区域。成纤维细胞型肉瘤，包括低级别黏液纤维肉瘤、恶性纤维组织细胞瘤和纤维肉瘤，在肿瘤细胞中显示出bcl-2的表达各异。我们的结果似乎表明，bcl-2可能在良性和恶性梭形细胞肿瘤中广泛分布。在其中一些情况中，尤其是孤立性纤维瘤、胃肠道间质瘤和滑膜肉瘤中，该标志物的强表达可能有助于鉴别诊断。
