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目的应用免疫组化标记提高膀胱炎症性肌纤维母细胞瘤的病理诊断正确率并提高对该肿瘤的认识。方法研究许昌市中心医院3例膀胱炎症性肌纤维母细胞瘤患者的临床资料、组织学形态,应用免疫组化抗体ALK、p53、cyokeratin(AE/AE3)、SMA、myoglobin、s-100、vimentin、desmin、CD34、CD117等进行染色观察。结果膀胱炎症性肌纤维母细胞瘤组织学为梭形肿瘤细胞,束状排列,可见黏液样背景,结合免疫组化P53、ALK、vimentin 3例均阳性表达,ki67增殖指数10%~25%,而不表达desmin、CD34、Myoglobin、S-100和CD117。2例SMA有轻微弱表达可明确诊断。结论病理诊断膀胱炎症性肌纤维母细胞瘤以组织学为基础,联合免疫组化抗体应用,特别是ALK、p53、AE1/AE3在该肿瘤的诊断中尤为有用,但病例数较少,需要大样本支持。
Objective To improve the accuracy of pathological diagnosis of bladder inflammatory myofibroblastoma by using immunohistochemical markers and to improve the understanding of this tumor. Methods The clinical data and histological changes of 3 patients with cystitis myoblastoma in the Central Hospital of Xuchang were studied. The expressions of ALK, p53, cytokeratin (AE / AE3), SMA, myoglobin, s-100, vimentin, desmin, CD34, CD117 and other staining. Results Bladder inflammatory myofibroblastoma was a spindle-shaped tumor cell with a bundle-like arrangement and a mucous-like background. The positive expression of P53, ALK and vimentin was observed in 10 cases, while the proliferation index of ki67 was 10% ~ 25% The expression of desmin, CD34, Myoglobin, S-100 and CD117.2 SMA patients with mild weak expression can be clearly diagnosed. Conclusions Pathological diagnosis of bladder inflammatory myofibroblastoma is histologically based and the use of combined immunohistochemical antibodies, especially ALK, p53, AE1 / AE3, is particularly useful in the diagnosis of this tumor but with fewer cases requiring large samples stand by.