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目的寻找有利于胰腺实性假乳头状肿瘤(SPT)和胰腺内分泌肿瘤(PEN)鉴别诊断的相对特异的免疫组化标记物。方法回顾性复习14例SPT和24例PEN的临床病理资料,免疫组化检测β-catenin、E-cadherin(ECD)、Syn、CgA、CD56、NSE和CK的表达。结果 PEN组,所有肿瘤细胞β-catenin为细胞膜、细胞质着色,ECD为细胞膜着色;SPT组,所有肿瘤细胞β-catenin着色异常,表现为细胞核着色,而ECD细胞膜着色消失;两组间比较P<0.05。PEN组Syn和CgA的阳性率要显著高于SPT组(100%∶71.4%,91.7%∶7.1%)。PEN组和SPT组之间CK、CD56、NSE的阳性率差异不显著。结论β-catenin和ECD是鉴别SPT和PEN最有用的免疫标记物。根据Syn和CgA染色结果进行SPT和PEN鉴别诊断时需谨慎,因为部分SPT Syn和CgA亦可为阳性。
Objective To search for specific immunohistochemical markers that are useful for the differential diagnosis of solid pseudopapillary tumors (SPT) and pancreatic endocrine tumors (PEN). Methods The clinical and pathological data of 14 cases of SPT and 24 cases of PEN were retrospectively reviewed. The expressions of β-catenin, E-cadherin, Syn, CgA, CD56, NSE and CK were detected by immunohistochemistry. Results In the PEN group, β-catenin of all tumor cells was the cell membrane, the cytoplasm was stained, and the ECD was the cell membrane staining. In the SPT group, the β-catenin staining of all the tumor cells was abnormal, showing staining of the nucleus and disappearance of the ECD cell membrane. 0.05. The positive rates of Syn and CgA in PEN group were significantly higher than those in SPT group (100%: 71.4%, 91.7%: 7.1%). There was no significant difference in the positive rates of CK, CD56 and NSE between PEN group and SPT group. Conclusion β-catenin and ECD are the most useful immunological markers to identify SPT and PEN. Care should be taken when differentiating SPT from PEN based on Syn and CgA staining, as some SPT Syn and CgA may also be positive.