嗅神经母细胞瘤的临床病理及免疫组化观察分析.doc

嗅神经母细胞瘤的临床病理及免疫组化观察分析 摘要：目的　探讨嗅神经母细胞瘤的临床、病理形态学及免疫组化特点。方法　收集12例嗅神经母细胞瘤的临床资料，用普通形态学方法及免疫组化染色观察形态特点。结果　按Kadish分期，A期无一例，B期7例，C期5例。组织学特征是瘤细胞以片状、梁索状排列，有Homer-wright、Flener菊形团，细胞间可见胞浆突起形成的嗜酸性纤维。多种抗体免疫组化染色：NSE 12例均为阳性，S-100 3例阳性，NF4例阳性，Vimentin 4例阳性，LCA、Keratin、HMB-45、Desmin均为阴性。结论　NSE对诊断嗅神经母细胞瘤有特异性价值，其它免疫组化联合检测有助于诊断及鉴别诊断。　　关键词：嗅神经母细胞瘤；病理学；临床；免疫组织化学　　中图分类号：R730.264　　　文献标识码：A　　　文章编号：1000-8578(2000)06-0441-03 The Clinicopathological and ImmunohistochemicalStudy of Oifactory Neuroblatoma CAO Jun,GAO Ping,HUANG Ying-gui,etYal（Department of pathology,Affiliated Hospital of Guangdong Medical College,Zhanjiang 524001,China） 　　Abstract:Objective Clinico-pathological and immunohistochemical features of olfactory neuroblatoma were studied.Methods Totally 12 patients accompanied with detailed date.HE staining and immunohistochemical stainngs were used.Results According to Kadish?s staging system,they were O case of stage A,7 cases of stage B,5 cases of stage C.The pathological feature were small tumor cells arranged in pieces or strips and acidophilic fibrillary which was interey toplasmic,Homer-Wright rosette and／or Flexner rosette were found in some cases.Immunohistochemistry showed that neuro-specific enolase (NSE) of 12 cases were positive;S-100 protein (S-100) of 3 cases and neurofilament protein (MF) of 4 cases and vimentin protein (vimentin). of 4 cases Positive,Keratin,Leucocyte common antigen (LCA),Melanoma (HMB45),Desmin protein (Desmin) were all negative.Conclusion NSE is the most useful diagnostic feature for olfactory neuroblastoma;NF,S-100,Keratin.LCA,Vimentin,HMB45,Desmin can help in diagnosis and distinguishing.　　Key words:Olfactory neuroblatoma;Pathology;Clinic;Immunohistochemical 　　嗅神经母细胞瘤是神经母细胞瘤的一种特殊类型，来自嗅基板的神经外胚成份或嗅膜的神经上皮成份，1924年由Berger首次报告。嗅神经母细胞瘤临床表现无特殊，病理形态上易与其它小细胞肿瘤相混淆，以往认为是一种较罕见的恶性肿瘤，随着对其认识的加深及新的诊断技术的应用，嗅神经母细胞瘤病例报道逐渐增多。我院从1987年至1998年共收治12例，对其我们进行了临床病理及免疫组化观察分析，以便更好的掌握其特点，提高诊断正确率。 1　材料与方法 1.1　标本　收集我院1987年至1998年经病理证实的嗅神经母细胞瘤12例，标本均用10%福尔马林固定，石蜡包埋切片。1.2　免疫