摘要
目的探讨胰腺黏液性非囊性腺癌的病理形态学特征和相关蛋白表达状态与生物学行为的关系。方法对249例胰腺外分泌癌中6例符合黏液性非囊性腺癌病例进行形态学观察,应用免疫组织化学EnVision法检测了p21ras、p21WAF1、p16、p33ING1、p53、ATM、MDM2、增殖细胞核抗原(PCNA)和细胞周期蛋白(Cy)D1、D3、A、B和E的表达,AB-PAS染色观察细胞内外黏液分布,同时对6例进行生存期随访。结果6例全部位于胰头部位,4例有十二指肠浸润,2例肝转移,2例局部淋巴结转移,1例周围神经浸润,具有相似的组织学特征。免疫组织化学染色阳性为p21ras5例,p21WAF13例,p161例,p33ING14例,p532例,ATM3例,MDM23例,PCNA6例,CyA3例,CyD13例,CyD34例,CyB4例,CyE6例。AB-PAS染色见细胞内、外黏液分布。随访结果2例死亡(分别为术后14、20个月),3例存活(分别为28、49、87个月),1例失访。结论胰腺黏液性非囊性腺癌具有一些独特的病理形态学特征和生物学行为,肿瘤细胞存在多种肿瘤相关蛋白的改变和细胞周期蛋白的过表达,显示较差的生物学行为和较强的侵袭能力,但预后可能比普通导管腺癌好。
Objective To determine the clinicopathologic characteristics and the relationship between related gene expression and pathobiologic behavior of pancreatic mucinous noncystic adenocarcinoma. Methods Among the 249 pancreatic carcinoma cases from the department files, 6 tumors were identified to meet the pathologic criteria of colloid carcinoma. Envision immunohistochemical staining technique was used to detect expression of p21 ras , p21 WAF1 , p16, p33 ING1 , p53, ATM, MDM2, PCNA, Cyclins (D1, D3, A, B and E). Intra- and extra- cellular mucin production were determined by AB-PAS staining. Clinically, all of 6 cases were followed to June, 2003. Results In all 6 cases, the tumors were located in the head of the pancreas and all displayed similar microscopic findings. Duodenal invasion was seen in 4 cases and perineural invasion was seen in 1 case. Tumor metastasis in the liver was seen in 2 cases and in the regional lymph nodes in 2 cases. Positive immunostaining was seen in 5 cases with p21 ras , 3 cases with p21 WAF1 , 1 case with p16, 4 cases with p33 ING1 , 2 cases with p53, 3 cases with ATM, 3 cases with MDM2, 6 cases with PCNA, 3 cases with cyclinA, 3 cases with cyclinD1, 4 cases with cyclinD3, 4 cases with cyclinB and 6 cases with cyclinE. Both extracellular and intracellular mucin was strongly positive for AB-PAS staining. Clinical follow-up found that 2 patients died of their tumors at 14 and 20 months. Three patients were alive after 28, 49 and 87 months of follow-up. One case were lost contact. Conclusions Pancreatic mucinous noncystic adenocarcinoma has distinct morphologic features and biologic behavior. Multiple gene products including many cyclins may be involved in the pathogenesis of pancreatic colloid carcinoma. The tumor has an aggressive behavior with a high frequency of invasion and metastases, though the prognosis could be better than that of ordinary ductal adenocarcinoma of pancreas.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2005年第7期389-392,共4页
Chinese Journal of Pathology
基金
长海医院学科建设计划经费资助
