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肾上腺皮质肿瘤神经内分泌学特性的初步研究
何昊玮1,郑军华2*,高建平1,徐丹枫3
0
(1.南京军区南京总医院泌尿外科,南京军区泌尿男科中心,南京 210002;2.同济大学附属第十人民医院泌尿外科,上海 200072;3.第二军医大学长征医院泌尿外科,上海 200003)
摘要:
目的:探讨肾上腺皮质肿瘤的神经内分泌学特性。方法:对长征医院1999年6月至2005年6月收治的99例肾上腺皮质肿瘤患者进行回顾性分析。应用单克隆抗体免疫组化技术链霉菌抗生物素蛋白过氧化酶连接法(SP法)检测99例肾上腺皮质肿瘤组织中神经特异性烯醇酶(neuron specific enolase,NSE)、嗜铬素A(CgA)、突触素(Syn)的表达,收集患者的一般资料,包括患者年龄、临床症状、检验结果、病理类型等,进行统计学处理。结果:三种蛋白在肾上腺皮质腺瘤中均有大量表达,NSE阳性率为80%,CgA阳性率为48.9%,Syn阳性率为75.6%。在皮质腺癌中的表达率为 NSE 77.8%,CgA 22.2%,Syn 77.8%。在正常肾上腺组织中的表达率为 NSE 20%,CgA 0%,Syn 10%。NSE、CgA、Syn三种蛋白在肾上腺皮质腺瘤和肾上腺皮质腺癌之间的表达没有显著性差异(P>0.05),但均比正常肾上腺组织明显升高(P<0.05)。结论:肾上腺皮质肿瘤无论腺瘤、腺癌,均表现出神经内分泌学特性,提示其发生与肾上腺皮质中的神经内分泌细胞的异常增殖有关。
关键词:  肾上腺皮质肿瘤;神经内分泌学;神经特异性烯醇酶;嗜铬素A  突触素
DOI:10.3724/SP.J.1008.2007.01072
基金项目:上海市科委基金(014119042, 054119604).
Neuroendocrinology of adrenalcortical tumors:a primary study
HE Haowei1, ZHENG Junhua2*, GAO Jianping1
(1. Department of Urology, Nanjing General Hospital, PLA Nanjing Military Area Command, Center of Urologic Andrology of PLA Nanjing Military Area Command,Nanjing 210002, China; 2. Department of Urology, the 10th People’s Hospital of Shanghai, Tongji University,Shangzheng 200072;3.Department of Urology, Chanzheng Hospital, Second Military Medical University, Shanghai 200003)
Abstract:
Objective:To investigate the neuroendocrine properties of adrenalcortical tumors. Methods: We retrospectively reviewed the clinical data of 99 adrenalcortical tumor patients, who were treated in Changzheng Hospital form June 1999 to June 2005. Expression of neuron specific enolase (NSE), chromogranin A (CgA) and synaptophysin (Syn) proteins were examined by immunohistochemistry (SP method) using monoclonal antibodies. The general data of patients, including the age, symptoms, laboratory findings, and pathological types, were collected and subjected to statistical analysis with SAS v6.12 software. Results: The expression of all the above 3 proteins was found in adrenalcortical adenoma tissues, with the positive rate of NSE being 80%, the positive rate of CgA being 48.9%, and the positive rate of Syn being 75.6%; the positive rates in the adrenalcortical carcinoma tissues were 77.8%, 22.2%, and 77.8%, respectively; and those in the normal adrenal tissues was 20%, 0%, and 10%, respectively. The positive rates of 3 proteins in adrenalcortical tumors was significantly higher than those in the normal adrenal tissues (P<0.05); there was no significant difference between those of different adrenalcortical tumors. Conclusion: Both adrenalcortical adenomas and adrenalcortical carcinomas possess neuroendocrine properties, indicating that their development is associated with abnormal differential of nuroendocrine cells in adrenal cortex.
Key words:  adrenal cortex neoplasms  neuroendocrinology  neuron specific enolase  chromogranin A  synaptophysin