SATB2在骨肉瘤病理诊断中的价值

发布时间：2018-04-06 20:29

本文选题：骨肉瘤　切入点：SATB2　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的:骨肉瘤的诊断到目前为止一直主要依靠影像学和组织学诊断,组织学上,由于部分不典型骨肉瘤组织中瘤细胞成骨能力较弱,骨样基质形成较少,往往难以与其他肉瘤和瘤样病变相互区分鉴别。在临床病理诊断过程中,常常需要特异性抗体来区分组织或肿瘤类型。本研究通过应用免疫组织化学方法检测SATB2在与骨相关的肿瘤和病变组织中的表达阳性率情况,探讨SATB2在诊断骨肉瘤中的价值。方法:本研究筛选出47例骨肉瘤,其中普通型骨肉瘤39例、小细胞性骨肉瘤3例、髓内高分化骨肉瘤3例和其它类型骨肉瘤2例。另外筛选出平滑肌肉瘤2例、骨母细胞瘤5例、骨化性肌炎5例、未分化多形性肉瘤5例、纤维结构不良4例、软骨肉瘤8例、Ewing肉瘤5例、纤维肉瘤6例和软骨母细胞瘤10例做对比研究。采用免疫组织化学法检测并分析SATB2蛋白在这些病变组织中的阳性表达程度。结果:1、SATB2在骨肉瘤中阳性表达率为83.0%(39/47),根据WHO分型,可将骨肉瘤细分为普通型骨肉瘤(骨母细胞型、成纤维细胞型、软骨母细胞型)、小细胞性骨肉瘤、髓内高分化骨肉瘤和其他类型骨肉瘤,并分别统计SATB2阳性表达率如下:(1)普通型骨肉瘤:SATB2在骨肉瘤活检组织中的阳性表达率为84.6%(33/39),其中在骨母细胞型骨肉瘤中阳性表达率为100%(26/26)、成纤维细胞型骨肉瘤中阳性表达率为50%(2/4)、软骨母细胞型骨肉瘤中阳性表达率为66.7%(2/3);而在瘤段切除的骨母细胞型骨肉瘤中阳性表达率为50%(3/6),显著低于活检的骨母细胞型骨肉瘤中阳性表达率;(2)小细胞性骨肉瘤:SATB2在小细胞性骨肉瘤活检组织中的阳性表达率为100%(3/3);(3)髓内高分化骨肉瘤:SATB2在髓内高分化骨肉瘤活检组织中的阳性表达率为33.3%(1/3);(4)其他类型骨肉瘤:SATB2在其他类型骨肉瘤活检组织中的阳性表达率为100%(2/2);2、骨母细胞瘤:SATB2在骨母细胞瘤中阳性表达率为100%(5/5);3、骨化性肌炎:SATB2在骨化性肌炎中阳性表达率为100%(5/5);4、软骨母细胞瘤:SATB2在软骨母细胞瘤中阳性表达率为20.0%(2/10);5、SATB2在纤维结构不良、软骨肉瘤、Ewing肉瘤和骨原发性梭形细胞肉瘤(未分化多形性肉瘤、纤维肉瘤和平滑肌肉瘤)中均为阴性表达。结论:SATB2作为新的成骨细胞标记物,在鉴别骨肉瘤和非成骨性恶性肿瘤时是重要的免疫组织化学补充指标,但对于区分骨肉瘤和其它成骨性病变意义有限。
[Abstract]:Objective: up to now, the diagnosis of osteosarcoma mainly depends on imaging and histology. Histologically, the osteogenic ability of tumor cells in some atypical osteosarcoma tissues is weak, and the formation of osteoid matrix is less.It is often difficult to differentiate from other sarcomas and tumor-like lesions.In clinicopathological diagnosis, specific antibodies are often required to distinguish tissue or tumor types.The purpose of this study was to investigate the value of SATB2 in the diagnosis of osteosarcoma by using immunohistochemical method to detect the positive rate of SATB2 expression in osteosarcoma.Methods: 47 cases of osteosarcoma were selected, including 39 cases of common type osteosarcoma, 3 cases of small cell osteosarcoma, 3 cases of intramedullary well-differentiated osteosarcoma and 2 cases of other types of osteosarcoma.In addition, 2 cases of leiomyosarcoma, 5 cases of osteoblastoma, 5 cases of ossifying myositis, 5 cases of undifferentiated pleomorphic sarcoma, 4 cases of fibrous dysplasia, 5 cases of chondrosarcoma and 8 cases of chondrosarcoma were selected.A comparative study was made between 6 cases of fibrosarcoma and 10 cases of chondroblastoma.Immunohistochemical method was used to detect and analyze the positive expression of SATB2 protein in these lesions.Results the positive expression rate of SATB2 in osteosarcoma was 83.0% / 47%. According to WHO classification, osteosarcoma could be subdivided into common type osteosarcoma (osteoblastoma type, fibroblast type, chondroblastoid type, small cell osteosarcoma).Intramedullary highly differentiated osteosarcoma and other types of osteosarcoma,The positive expression rate of SATB2 was 20.0 / 10 / 10 and SATB2 was found in fibrous dysplasia.The expression of Ewing sarcoma and primary spindle cell sarcoma (undifferentiated pleomorphic sarcoma fibrosarcoma and leiomyosarcoma) were negative in chondrosarcoma.Conclusion as a new osteoblast marker, the ratio SATB2 is an important immunohistochemical supplement in differentiating osteosarcoma from non-osteogenic malignant tumor, but it is of limited significance in differentiating osteosarcoma from other osteogenic lesions.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R738.1

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