[关键词]
[摘要]
目的:探讨睑板腺癌(MGC)的临床病理及免疫组化(IHC)特征。
方法:连续收集我院2015-01-01/2020-12-31术后病理确诊MGC患者,回顾分析临床病理资料。所有病例癌组织进行IHC染色。IHC方法采用En-Vision两步法,DAB显色,苏木精复染。
结果:共收集50例患者,年龄26-80(中位60)岁,男21例,女29例,男女性别比例1:1.38。发病部位以上眼睑占66%(33/50); 组织病理学上,中-低分化者占70%(35/50)。MGC患者IHC指标表达率:GATA-3占98%(49/50)、EMA占98%(49/50)、CAM5.2占84%(42/50)、AR占82%(41/50)、MSH2占100%(50/50)、MSH6占100%(50/50)、MLH1占100%(50/50)、PMS2占100%(50/50)、Ki67占50%-90%。本组病例随访12-72 mo,复发5例,死亡0例。
结论:MGC组织病理学诊断应着重观察癌细胞胞浆,以寻找皮质腺分化的相关线索。使用IHC辅助诊断时,需要多项指标进行综合分析,大多数MGC癌细胞呈GATA-3、EMA、AR、CAM5.2阳性,Ki67增殖指数较高。另外,诊断MGC时,需同时进行Muir-Torre综合征相关IHC指标筛查。
[Key word]
[Abstract]
AIM: To explore the clinicopathological and immunohistochemistry(IHC)characteristics of meibomian gland carcinoma(MGC).
METHODS: Patients who were pathologically diagnosed as MGC from January 1, 2015 to December 31, 2020 in our hospital were enrolled, and their clinicopathological information was retrospectively analyzed. Cancer tissues from all the cases were IHC stained. En Vision two-step method, DAB staining, as well as hematoxylin re-staining were applied in the IHC assay.
RESULTS: A total of 50 patients with 21 males and 29 females(1:1.38)were enrolled in the study, ranging from 26 to 80 years old, with a median age of 60 years. The upper eyelid, which was the predilection site, accounting for 66%(33/50). Histopathologically, moderately or poorly differentiated was in the majority(35/50, 70%). The expression rates of IHC parameters of MGC patients were as follows: GATA-3(49/50, 98%), EMA(49/50, 98%), CAM5.2(42/50, 84%), AR(41/50, 82%), MSH2(50/50, 100%), MSH6(50/50, 100%), MLH1(50/50, 100%), PMS2(50/50, 100%), Ki67(positive, 50%-90%). All the patients were followed up for 12 to 72 mo, with 5 cases of recurrence and 0 deaths.
CONCLUSION: Pathological diagnosis of MGC should focus on observing cancer cells' cytoplasm to find relevant clues for cortical gland differentiation. Comprehensive analysis of multiple indicators is required when using IHC to assist diagnosis. For most MGC cancer cells, positive expressions of GATA-3, EMA, AR, CAM5.2 and a high Ki67 proliferation index could be always found. In addition, screening for Muir-Torre syndrome related IHC indicators could be also performed in diagnosing MGC simultaneously.
[中图分类号]
[基金项目]
陕西省重点研发计划(No.2022SF-504)