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目的 应用免疫组织化学技术观察免疫反应性肾上腺髓质素 (ir ADM)在人正常肾上腺、良恶性肾上腺肿瘤及肾上腺皮质增生组织中的分布特点。方法 对人正常肾上腺皮质 (n =1 0 )和髓质 (n =1 0 )、嗜铬细胞瘤 (n =31 )、原发性醛固酮增多症的肾上腺皮质腺瘤 (n =1 3)和增生 (n =9)、皮质醇增多症的肾上腺皮质腺瘤 (n =1 2 )、增生 (n =1 0 )和腺癌 (n =4)、无功能肾上腺皮质腺癌组织 (n =7)进行ir ADM的免疫组化染色。结果 1 0例人正常肾上腺髓质组织均显示ir ADM染色阳性 ;31例嗜铬细胞瘤组织中 1 6例染色阳性 ,大部分嗜铬细胞瘤组织中的ir ADM免疫组化染色强度低于正常肾上腺髓质组织 (P <0 .0 1 )。在嗜铬细胞瘤中阵发性高血压组阳性染色例数多于持续性高血压组 (P <0 .0 5) ;人正常肾上腺皮质及各组皮质病变组织中 ,ir ADM免疫组化染色均为阴性。结论 ir ADM在嗜铬细胞瘤组织中分布呈不均一性 ,可能与嗜铬细胞瘤患者血压表现的多样化有关 ,应进一步探讨ADM在嗜铬细胞瘤发病中的病理生理作用
Objective To observe the distribution of immunoreactive adrenomedullin (ir ADM) in human normal adrenal gland, benign and malignant adrenal neoplasms and adrenocortical hyperplasia by immunohistochemistry. Methods Adrenal cortical adenomas (n = 13) and adenocarcinoma of primary aldosteronism in normal adrenal cortex (n = 10), medulla (n = 10), pheochromocytoma (N = 9), adrenocortical adenoma (n = 12), hyperplasia (n = 10) and adenocarcinoma ) For immunohistochemical staining of ir ADM. Results All the normal adrenal medulla tissues were positive for ir ADM staining. In the 31 cases of pheochromocytoma, 16 cases were positive staining, and the intensity of ir ADM staining in most pheochromocytoma tissues was lower than normal Adrenal medulla tissue (P <0.01). In pheochromocytoma, the number of positive staining for paroxysmal hypertension group was higher than that of persistent hypertension group (P <0.05). In normal human adrenal cortex and cortical lesions, ir ADM staining All negative. Conclusion The distribution of ir ADM is heterogeneous in the tissues of pheochromocytoma, which may be related to the diversity of blood pressure in patients with pheochromocytoma. The pathophysiology of ADM in the pathogenesis of pheochromocytoma should be further explored