我的博文
病理诊断免疫组化 胃肠道、肝胆胰
第一节 食管肿瘤
1.Barrett’s食管
阳性:CK20,MUCs,CDX2,P53
2.鳞状细胞癌(普通型)
阳性:CAM5.2,AE1/AE3,CK5/6,34βE12,CK14,P63(部分),CK19
阴性:CK7,CK20,WT-1,CD5,TTF-1
3.基底细胞样鳞癌
阳性:Bcl-2,CK5/6,CK13,CK14,CK19,P63,S-100
阴性:CAM5.2,AE1/AE3
4.腺癌
阳性:CK7,CK20
阴性:P63
5.腺样囊性癌
阳性:CAM5.2,AE1/AE3,CD117
(导管分化细胞) 34βE12,CEA
(肌上皮分化细胞) S-100,SMA,vimentin,P63
阴性:CgA,Syn
6.黏液表皮样癌
阳性:(鳞状上皮样区域) 34βE12,CK14,P63
(腺上皮区域) CK7,CEA
7.梭形细胞分化癌或肉瘤样癌
阳性:CAM5.2,AE1/AE3,vimentin
阴性:desmin
8.平滑肌瘤
阳性:SMA,desmin,MSA,calponin
阴性:CD34,CD117,S-100
9.平滑肌肉瘤
阳性:SMA,desmin,vimentin
阴性:CD34,CD117
10.胃肠道间质瘤
阳性:CD34,CD117,PDGFRA,DOG1,PKCθ
11.神经内分泌肿瘤
阳性:Syn,CgA,NSE,TTF-1,CD56
阴性:CK19,CK20,34βE12
12.横纹肌肉瘤
13.滑膜肉瘤
14.Kaposi肉瘤
阳性:CD31,CD34
15.颗粒细胞瘤
阳性:S-100,CD57,vimentin
阴性:desmin,CD34,CD117,CAM5.2,EMA,CEA
16.恶性黑色素瘤
阳性:vimentin,S-100,HMB45,MART/melan-A,tyrosinase
阴性:CK,CEA
17.淋巴瘤(大B细胞淋巴瘤和MALT淋巴瘤多见)
第二节 胃部肿瘤
1.胃腺癌
阳性:CAM5.2,Pan-CK,CK7,CK20,CK18,CK19,CDX2,CEA(部分),villin(部分),Her-2
阴性:CK5/6,vimentin,P63(鳞化区域可阳性),TTF-1,CA125(少量)
2.含神经内分泌分化的腺癌
阳性:CKs,CgA,Syn
阴性:CD56
3.印戒细胞癌
阳性:CDX2,CK20,CEA
阴性:GCDFP-15,ER
4.高分化神经内分泌肿瘤或小细胞癌
阳性:CgA,Syn,CDX2
阴性:CK20,TTF-1,CK5/6
5.肉瘤样癌
6.胃肠道间质瘤
阳性:CD117,CD34,CD99,SMA,HHF-35(25%-50%),CK18(10%)
阴性:Syn(<5%),desmin(2%),CgA,S-100
7.神经鞘瘤
阳性:S-100,CD57(Leu7),GFAP
阴性:CD117,CD34,SMA
8.纤维瘤病
阳性:vimentin,desmin,β-catenin
阴性:CD117,CD34(少量细胞可阳性)
9.孤立性纤维瘤
阳性:CD34,CD99,SMA,Bcl-2
阴性:CD117
10.肝样腺癌
阳性:AFP,Hepatocyte
11.绒毛膜癌
阳性:β-hCG,PLAP
第三节 小肠肿瘤
1.神经内分泌肿瘤
阳性:CgA,Syn,CD57,villin,CEA,CDX2,CK20(25%),somatostatin
阴性:CK7,TTF-1
2.GIST
阳性:CD117,CD34,Bcl-2,SMA,S-100(20%)
阴性:desmin,CgA
3.远端小肠腺癌(表型类似结肠癌)
阳性:CK18,CK19,CK20,CDX2,villin,MUC1,MUC5AC(33%)
阴性:CK7,CK5/6,P63,vimentin
4.壶腹部腺癌(表型类似胰胆管腺癌)
阳性:CK18,CK19,CK7(50%),CK20(50%),CDX2,MUC1,MUC5AC(33%)
阴性:CK5/6,P63,vimentin
第四节 阑尾肿瘤
1.神经内分泌肿瘤
阳性:CgA,Syn,E-cadherin,β-catenin,CK20,CDX2
阴性:CEA,CK7
2.不产生黏液的腺瘤及腺癌
阳性:CK20,CK7
3.产生黏液的腺瘤及腺癌
阳性:CK8,CK18,CK19,CK20,CDX2,villin,MUC2,MUC5A,MUC1(20%)
第五节 结直肠肿瘤
1.神经鞘瘤
阳性:S-100,GFAP,CD34
阴性:CD117
2.神经纤维瘤
阳性:S-100,neurofilament
阴性:CD117
3.GIST
阳性:CD117,CD34,CD99,SMA
阴性:GFAP,desmin,S-100,neurofilament
4.平滑肌瘤
阳性:SMA,MSA,desmin
阴性:CD117,CD34,S-100
5.神经内分泌肿瘤
(右半结肠)阳性:serotonin,CgA,Syn,CK20(50%),CK7(25%)
阴性:S-100,TTF-1
(直乙结肠)阳性:CgA,Syn,PAP(少数)
阴性:S-100,PSA,P504S
6.腺癌
阳性:CK20,CDX2,villin,MUC1,MUC2,S-100(<20%),PLAP(部分,膜阳性),CA125
阴性:CK7(5%可阳性),CgA,Syn,MUC5A,CK5/6,GCDF-15,TTF-1,HPC
7.高分化神经内分泌肿瘤
阳性:Syn,低分子量CK,CAM5.2,35βH11 (含有非角化鳞癌成分)34βE12,CK5/6,P63
阴性:CK20,CgA,CD57,CD117
8.肉瘤样癌
第六节 肛管肿瘤
1.鳞状细胞癌及其亚型
2.腺癌
阳性:CK7
阴性:CK20
3.Paget’s病
阳性:AE1/AE3,CK7,CK20(部分),CEA,GCDFP-15
阴性:34βE12,S-100
第七节 胰腺肿瘤
1.胰腺神经内分泌肿瘤
阳性:PGP9.5,CgA,Syn,CK8,CK18,CAM5.2,AE1/AE3(部分)
阴性:CK7,CK20,TTF-1,CDX2,HepPar1,Villin
2.低分化神经内分泌癌
阳性:CD56,CD57,CgA,Syn,calcitonin
3.导管内乳头状黏液性肿瘤
阳性:CK7,CDX2,MUC2,MUC5AC,DUPAN-2,CA19-9,hMLH1,hMLH2,hMLH6
阴性:CK20,CEA
4.黏液性囊性肿瘤
阳性:CK7,CK20,CA125,CA19-9,MUC5A,Smad4
(卵巢样间质区域)vimentin,SMA,MSA,ER(20%-80%),α-inhibin
阴性:MUC1,MUC2
5.浆液性囊腺瘤
阳性:AE1/AE3,EMA,MUC1,MUC6,CA19-9
阴性:CEA,CgA,Syn
6.导管腺癌
阳性:EMA,CAM5.2,CA19-9,CK19,CK7,CK20,MUC1,MUC4,MUC5A,CDX2,Smad4,CD5,CD7,mesothelin
部分阳性:CgA,Syn,CA125,villin,CK5/6
阴性:AFP,PAP,PSA,WT-1,TTF-1,MUC2,HPC,vimentin,ER,PR
7.浸润性黏液想腺癌
阳性:MUC2
阴性:CA125,MUC1
8.含破骨样巨细胞的未分化癌
阳性:pan-CK,vimentin,AE1/AE3,CAM5.2,35βH11,CK8,CK18,CK19
(破骨样巨细胞)CD68,LCA,CD71,α-1-antichymotrypsin
阴性:EMA,CEA,HMB45,MART-1
9.腺泡细胞癌
阳性:AE1/AE3,CAM5.2,CK7,CK8,CK19,trypsin,α-1-antichymotrypsin,Syn(10%-50%)
阴性:CEA,CgA,vimentin,AFP
10.实性假乳头状瘤
阳性:α-1-antichymotrypsin,vimentin,β-catenin
(部分表达)CK20,AE1/AE3,CAM5.2,CK7,CD10,Syn,ER,PR
阴性:EMA,CEA,AFP,CA19-9,S-100
11.血管周上皮样细胞瘤
阳性:actin,HMB45,Myo-D1
阴性:CD117,CD34,SMA,AE1/AE3,CAM5.2,CgA,Syn
第八节 肝及胆管肿瘤
1.胆汁性肝硬化及硬化性胆管炎
阳性:(小胆管上皮)CK7,CK19,CD31/CD34
2.肝细胞腺瘤
阳性:CK8,CK18,HPC
阴性:CK7,CK19,CK20,CA19-9,34βE12
3.胆管错构瘤及腺瘤
阳性:CK7,CK19
阴性:CK20,MUC1,CEA
4.肝母细胞瘤
阳性:AFP,CgA,CKs,vimentin
5.普通型肝细胞癌
阳性:CK8,CK18,CAM5.2,OSCAR,AFP(高级别肝细胞癌阴性),HPC,AE1/AE3(少数),CD56(弱),CD31/34(内皮细胞),EMA,CEA(胆管型)
阴性:CK7(少数阳性),CK20(20%阳性),CK17,CA19-9,Calretinin,α-inhibin,TTF-1,CgA,Syn,MART-1,CK5/6,ER
6.具有胆管分化的肝细胞癌
阳性:AE1/AE3,CK7,CK19,CEA
7.梭形细胞肝细胞癌
阳性:vimentin,CAM5.2,HPC
阴性:AFP
8.纤维板层型肝细胞癌
阳性:CK8,CK18,CAM5.2,HPC,CK7,AFP(20%),α-1-antichymotrypsin
9.胆管癌
阳性:CK7,CK8,CK18,CK19,CAM5.2,CA19-9,CEA,MOC-31,CDX2(75%),CK17(50%),CK20(20%)
阴性:HPC,AFP,Syn,GCDFP-15
10.梭形细胞胆管癌或肉瘤样癌
阳性:vimentin,CEA,低分子量角蛋白(CAM5.2,AE1/AE3,EMA)
阴性:AFP,S-100
11.混合性肝细胞-胆管癌
12.低分化/未分化癌
阳性:CK7,CK19
阴性:CEA,CA19-9,AFP,HPC
13.胆管囊腺瘤或癌
阳性:AE1/AE3,CA19-9,CEA,CK7,CK20,CA125,vimentin,SMA,desmin
14.神经内分泌肿瘤(低级别及高级别)
共0条评论