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目的 探讨食管癌肉瘤的组织发生学.方法 应用免疫组织化学LSAB法检测20例食管癌肉瘤的石蜡切片中Keratin,EMA,Vimentin,Actin,Desmin,Myoglobin,NSE,S-100,MAC 387,a1-AT,al-ACT和Lysozyme12种标记.结果癌肉瘤中的癌成份上皮性标记均为阳性.16例鳞癌Keratin +++,2例腺样囊性癌Keratin++,EMA++;1例粘液表皮样癌Keratin+++,EMA+;1例小细胞性未分化癌Keratin+,NSE十+,S-100++.肉瘤成份20例间叶性标记Vimentin+++,其中同时表达Actin++8例,又表达Desmin++6例,和Myoglobin++2例.另同时表达MAC387+十,S-100++,al-AT++,al-ACT++和Lysozme++6例.显示间叶肉瘤成份,同时伴有恶纤组、肌源性、神经纤维性、骨和软骨肉瘤等成份分化.20例癌肉瘤中肉瘤成份与上皮性和问叶性标记共同表达者11例.结论 免疫组化测定癌肉瘤中肉瘤成份上皮性和间叶性标记共同阳性者命名为肉瘤样癌是无可争议的.而瘤肉瘤中,癌成份和肉瘤成份分别表达上皮性和间叶性标记时,仍可沿用癌肉瘤的命名.如肉瘤成份完全显示上皮性标记的应属于低分化癌的范畴.对癌肉瘤中上皮性和问叶性分化谱系的认识,尚有待进一步验证.
Objective To investigate the histopathology of esophageal carcinosarcoma. Methods Immunohistochemical LSAB method was used to detect the expression of Keratin, EMA, Vimentin, Actin, Desmin, Myoglobin, NSE, S-100, MAC 387, a1 in paraffin sections from 20 cases of esophageal sarcoma. AT, al-ACT and Lysozyme 12 markers. Results Carcinosarcomas were positive for cancerous epithelial markers. 16 cases of squamous carcinoma Keratin +++, 2 cases of adenoid cystic carcinoma Keratin++, EMA++; 1 case of mucoepidermoid carcinoma Keratin+++, EMA+; 1 case of small cell undifferentiated carcinoma Keratin+, NSE 10+, S-100++. 20 cases of sarcoma with vimentin+++, 8 cases of Actin++ and 6 cases of Desmin++. , And Myoglobin++ 2 cases. Simultaneous expression of MAC387+ X, S-100++, al-AT++, al-ACT++, and Lysozme++ 6 cases. Mesothelionoma composition, accompanied by malignant fibrosis, myogenic Differentiation of nerve fibres, bone and chondrosarcoma etc. In 20 cases of carcinosarcoma, sarcoma was co-expressed with epithelial and interspecies markers in 11 cases. Conclusion Immunohistochemistry for the determination of epithelial and mesenchymal sarcoma components in carcinosarcoma It is undisputed that sarcomatoid carcinoma is named as a co-positive marker. In tumoral sarcoma, cancerous components and sarcoma components express epitheliality, respectively. In the case of mesenchymal markers, the nomenclature of carcinosarcomas can still be used. For example, sarcoma components that fully express epithelial markers should fall into the category of poorly differentiated carcinoma. The understanding of the epithelial and interspecific differentiation of the carcinosarcoma needs further understanding. verification.