中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2012年
2期
91-96
,共6页
许霞%刘卫平%杨群培%王威亚%廖殿英%赵莎%毕成峰%林莉%闵敏
許霞%劉衛平%楊群培%王威亞%廖殿英%趙莎%畢成峰%林莉%閔敏
허하%류위평%양군배%왕위아%료전영%조사%필성봉%림리%민민
组织细胞增多症,郎格尔汉斯细胞%免疫表型分型
組織細胞增多癥,郎格爾漢斯細胞%免疫錶型分型
조직세포증다증,랑격이한사세포%면역표형분형
Histiocytosis,Langerhans-cell%Immunophenotyping
目的 观察Langerhans细胞组织细胞增生症(LCH)的临床病理特征,了解langerin、CD1a及S-100蛋白表达在LCH诊断中的作用.方法 对1992年1月至2008年12月18年间四川大学华西医院病理科档案资料诊断的258例LCH进行了临床和组织病理学的回顾性研究.采用免疫组织化学EnVision法,检测CD1 a、langerin及S-100蛋白的表达情况.结果 258例LCH患者年龄≥16岁或≤2岁的分别为126例(48.8%)和37例(14.3%),其余95例(36.8%)患者的年龄介于二者之间.临床上,258例LCH共有364处病变,其中骨骼病变281处(77.2%),且以颅骨累及为多,有112处(39.9%),其次为淋巴结25处(6.9%)和皮肤14处(3.8%).201例(77.9%)为单系统、单病灶;21例(8.1%)为单系统、多个病灶;26例(10.1%)为多系统、多个病灶;2例(0.8%)为肺LCH,8例(3.1%)不能分类.组织学上,258例LCH共265个样本中均见Langerhans细胞增生,166例(62.6%)见不等量多核巨细胞;嗜酸性粒细胞是主要的非肿瘤性细胞成分,57例(21.5%)可见嗜酸性脓肿;29例(10.9%)有片状凝固性坏死;124例(46.8%)可见死骨.免疫表型检测,100%(206/206)病例之瘤细胞表达CD1a,S-100蛋白和langerin的表达率分别为99.1% (209/211)和98.5%(193/196),三者的阳性表达率差异无统计学意义(P>0.05).结论 此组LCH患者以成年患者为多,多系统病变所占比例较低.在LCH中,langerin、CDla及S-100蛋白表达的敏感性差异无统计学意义,CDla及langerin是LCH诊断必不可少的标志物.
目的 觀察Langerhans細胞組織細胞增生癥(LCH)的臨床病理特徵,瞭解langerin、CD1a及S-100蛋白錶達在LCH診斷中的作用.方法 對1992年1月至2008年12月18年間四川大學華西醫院病理科檔案資料診斷的258例LCH進行瞭臨床和組織病理學的迴顧性研究.採用免疫組織化學EnVision法,檢測CD1 a、langerin及S-100蛋白的錶達情況.結果 258例LCH患者年齡≥16歲或≤2歲的分彆為126例(48.8%)和37例(14.3%),其餘95例(36.8%)患者的年齡介于二者之間.臨床上,258例LCH共有364處病變,其中骨骼病變281處(77.2%),且以顱骨纍及為多,有112處(39.9%),其次為淋巴結25處(6.9%)和皮膚14處(3.8%).201例(77.9%)為單繫統、單病竈;21例(8.1%)為單繫統、多箇病竈;26例(10.1%)為多繫統、多箇病竈;2例(0.8%)為肺LCH,8例(3.1%)不能分類.組織學上,258例LCH共265箇樣本中均見Langerhans細胞增生,166例(62.6%)見不等量多覈巨細胞;嗜痠性粒細胞是主要的非腫瘤性細胞成分,57例(21.5%)可見嗜痠性膿腫;29例(10.9%)有片狀凝固性壞死;124例(46.8%)可見死骨.免疫錶型檢測,100%(206/206)病例之瘤細胞錶達CD1a,S-100蛋白和langerin的錶達率分彆為99.1% (209/211)和98.5%(193/196),三者的暘性錶達率差異無統計學意義(P>0.05).結論 此組LCH患者以成年患者為多,多繫統病變所佔比例較低.在LCH中,langerin、CDla及S-100蛋白錶達的敏感性差異無統計學意義,CDla及langerin是LCH診斷必不可少的標誌物.
목적 관찰Langerhans세포조직세포증생증(LCH)적림상병리특정,료해langerin、CD1a급S-100단백표체재LCH진단중적작용.방법 대1992년1월지2008년12월18년간사천대학화서의원병이과당안자료진단적258례LCH진행료림상화조직병이학적회고성연구.채용면역조직화학EnVision법,검측CD1 a、langerin급S-100단백적표체정황.결과 258례LCH환자년령≥16세혹≤2세적분별위126례(48.8%)화37례(14.3%),기여95례(36.8%)환자적년령개우이자지간.림상상,258례LCH공유364처병변,기중골격병변281처(77.2%),차이로골루급위다,유112처(39.9%),기차위림파결25처(6.9%)화피부14처(3.8%).201례(77.9%)위단계통、단병조;21례(8.1%)위단계통、다개병조;26례(10.1%)위다계통、다개병조;2례(0.8%)위폐LCH,8례(3.1%)불능분류.조직학상,258례LCH공265개양본중균견Langerhans세포증생,166례(62.6%)견불등량다핵거세포;기산성립세포시주요적비종류성세포성분,57례(21.5%)가견기산성농종;29례(10.9%)유편상응고성배사;124례(46.8%)가견사골.면역표형검측,100%(206/206)병례지류세포표체CD1a,S-100단백화langerin적표체솔분별위99.1% (209/211)화98.5%(193/196),삼자적양성표체솔차이무통계학의의(P>0.05).결론 차조LCH환자이성년환자위다,다계통병변소점비례교저.재LCH중,langerin、CDla급S-100단백표체적민감성차이무통계학의의,CDla급langerin시LCH진단필불가소적표지물.
Objectives To observe the clinicopathologic features of Langerhans cell histiocytosis (LCH),and to evaluate the values of langerin,CD1a and S-100 protein expression in diagnosis of the tumor.Methods Total 258 cases of Langerhans cell histiocytosis in the past 18 years ( from 1992 to 2008 )were collected,morphologic review and immunohistochemical staining were performed. Results In all 258 cases,the ages of patients older than 16 years or younger than 2 years were 126 (48.8%) and 37 ( 14.3% ),respectively,in the remaining 95 (36.8% ) of the cases,the age of the patients ranged from 2 to 16 years.For all of 258 cases,there were 364 diseased sites. Bony lesions accounted for 77.2%(281 cases),especially the skull (112 cases,39.9% ),followed by lymph node (25 cases,6.9% ) and skin ( 14 cases,3.8% ).Clinically,unisystem or unifocal disease was predominant (201 cases,77.9% ),followed by unisystem and muhifocal disease (21 cases, 8.1%), multi-system disease (26 cases,10.1% ),isolated pulmonary LCH (2 cases,0.8% ),and unclassified (8 cases,3.1% ).Histologically,variable number of Langerhans cells was present in 265 samples of 258 cases.Muhinucleated giant cells were found in 166 (62.6% ) of the samples.Eosinophils were the major infiltrating non-neoplastic cells,and eosinophilic abscess was seen in 57 cases (21.5%).Coagulative necrosis and dead bone were detected in 29 ( 10.9% ) and 124 (46.8% ) of the cases,respectively.Immunohistochemically,the expression of S-100 protein,CD1 a and langerin was 99.1% (209/211),100% (206/206) and 98.5% (193/196),respectively,and the sensitivity of them had no statistical difference.Conclusions In this group of LCH cases,the ratio of adult patients is high,but the proportion of multi-organ lesion is low. No significant difference of the sensitivity is found among langerin,CD1a and S-100 expression in diagnosis of LCH.