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病理报告单上的免疫组化怎么看?肿瘤免疫组化汇总-神经系统肿瘤部分

 e药安全 2020-12-01

神经系统肿瘤


星形细胞瘤

1.毛细胞星形细胞瘤(WHO I)

阳性:GFAP

2.室管膜下巨细胞星形细胞瘤(WHO I)

阳性:GFAPS-100

3.弥漫性星形细胞瘤(WHO II)

阳性:VimentinGFAPS-100SOX2CaveolinOligo-2(91%),一些PCKP53(50%)

4.毛黏液样星形细胞瘤

阳性:GFAPS-100,一些SYN

阴性:NFCgA 

5.多形性黄色星形细胞瘤(WHO II)

阳性:GFAPS-100CD34,一些SYN,一些NF Class III β-tubulinMAP2

6.间变型星形细胞瘤(WHO III)

阳性:GFAPS-100SOX2caveolin70%-90% P53

7.伴有神经毡样岛的胶质神经元肿瘤(WHO II/III)

阳性:胶质成分GFAP,神经毡样岛SYN,神经节细胞样细胞NeuNHuP53

8.多形性胶质母细胞瘤(WHO IV)

阳性:GFAPS-100SOX2caveolinvimentin>50%PCK70%-90%P53

阴性:CAM5.2CK7CK20 

9.巨细胞胶质母细胞瘤(WHO IV)

阳性:70%-90% P53

10.胶质肉瘤(WHO IV)

阳性:上皮分化区可呈CAM5.2CK7CK20

阴性:GFAP

少突胶质肿瘤

1.少突胶质瘤(WHO II)

阳性:Oligo-2S-100CD57SOX2

阴性caveolin

2.间变型少突胶质瘤(WHO III)

室管膜肿瘤

1.室管膜下瘤(WHO II)

阳性:GFAPNCAMNSE

2.黏液乳头状室管膜瘤(WHO I)

阳性:GFAPvimentinS-100AB/PAS

阴性:CK

3.室管膜瘤(WHO II)

间变型室管膜瘤(WHO III)

阳性:EMACK7CAM5.2CK34βE12GFAPvimentinS-100SOX2nestinEMACD99TTF-1NeuN

脉络丛肿瘤

脉络丛乳头状瘤(WHO I)

不典型脉络丛乳头状瘤(WHO II)

脉络丛乳头状癌(WHO III)

阳性:vimentinS-100GFAPtransthyretinCD99PCKCK7EMApodoplaninKir7.1

阴性:SOX2caveolinNeuNCEAERBer-Ep4TTF-1CK20

其他神经上皮肿瘤

1.星形母细胞瘤

阳性:GFAPS-100vimentinEMALCK

阴性:CAM5.2PCK 

2.血管中心性胶质瘤(WHO I)

阳性:GFAPS-100vimentinpodoplaninEMA

阴性:NSESynCgANeuN

3.第三脑室脊索样胶质瘤(WHO II)

阳性:GFAPvimentinS-100EMAEGFRmerlin

阴性:P53P21MDM2CK

神经元肿瘤、胶质神经元混合性肿瘤

1.婴儿促纤维增生性星形细胞瘤

婴儿促纤维增生性节细胞胶质瘤(WHO I)

阳性:GFAPS-100SynNF

2.胚胎发育不良性神经上皮肿瘤

阳性:S-100GFAPSynNF

3.神经节细胞胶质瘤(WHO IIII)和神经节细胞瘤(WHO I)

阳性:S-100GFAPCD34SOX2SynNFMAP2NeuN

4.小脑发育不良性神经节细胞瘤(WHO I)

阳性:S-100SynNFp-AKTp-S6Leu-4L7PEP19calbindin

阴性:PTEN

5.乳头状胶质神经元肿瘤(WHO I)

阳性:SynNSECD56β-tubulinNeuNNFGFAPOligo-2

6.第四脑室伴有菊形团形成的胶质神经元肿瘤(WHO I)

阳性:SynNSEMAP2GFAPS-100

7.中枢神经细胞瘤(WHO II)和脑室外神经细胞瘤

阳性:SynNeuN

阴性:GFAPNFCgA

8.小脑脂肪神经细胞瘤(WHO II)和脑室外神经细胞瘤

阳性:NSEMAP2SynGFAPNeuN

松果体区肿瘤

1.松果体细胞瘤(WHO I)

阳性:Retinal S-antigenSynNSENFβ-tubulin(Class III)tauPGP9.5CgA

2.中等分化的松果体实质肿瘤(WHO II)

阳性:SynNSENFRetinal S-antigenCgA

3.松果体母细胞瘤(WHO III)

阳性:SynNSENFβ-tubulin(Class III)CgARetinal S-antigen

4.松果体区乳头状肿瘤(WHO II/III)

阳性:PCKCAM5.2CK18vimentinS-100NSEMAP2NCAMtransthyretinGFAPEMA

阴性:NF

胚胎性肿瘤

1.髓母细胞瘤

阳性:神经细胞标志(SynNSENeuNNFβ-tubulin)GFAPPCKEMA

阴性:CD99SOX2

2.中枢神经系统的原始神经外胚叶瘤(WHO IV)

阳性:SynNSENeuNNFβ-tubulinvimentinGFAP

3.髓上皮瘤(WHO IV)

阳性:nestinvimentinCKEMANFSynβ-tubulinGFAP

4.室管膜母细胞瘤(WHO IV)

阳性:S-100vimentin

5.不典型畸胎样或横纹肌样瘤(WHO IV)

阳性:GFAPS-100SynNFvimentinSMAEMA

神经鞘瘤、神经纤维瘤、神经束膜瘤、恶性外周神经鞘瘤

脑膜肿瘤

脑膜瘤(WHO I)

不典型脑膜瘤(WHO II)

间变型脑膜瘤(WHO II)

阳性:vimentinclaudin 1PCKCK7CK19CAM5.2S-100EMA

阴性:CD34GFAP

脑膜黑色素细胞瘤、弥漫性黑色素细胞增生和恶性黑色素瘤

阳性:S-100Melan-A

淋巴造血组织肿瘤

生殖细胞肿瘤

1.生殖细胞瘤

阳性:PLAPCD117OCT-4;若有合体滋养叶细胞样成分,可呈β-HCGh-PLCK

阴性:CD30AFP

2.胚胎癌

阳性:CKPLAPCD30OCT-4

阴性CD117AFPEMA

3.卵黄囊瘤或内胚窦瘤

阳性:AFPCK

阴性:CD117OCT-4β-HCGh-PLCD30

4.绒毛膜癌

阳性:β-HCGh-PLCK

阴性:CD117OCT-4CD30AFP

5.畸胎瘤和混合型生殖细胞肿瘤

鞍区肿瘤

1.腺垂体梭形细胞嗜酸细胞瘤(WHO I)

阳性:vimentinEMAS-100Galectin-3

阴性:CKGFAPSynCgASMAdesminCD34

2.神经垂体细胞瘤(WHO I)

阳性:S-100GFAP

阴性:CKSynCgA

3.神经垂体颗粒细胞瘤(WHO I)

阳性:S-100

4.颅咽管瘤(WHO I)

阳性:PCKHCKLCKP63CK7β-catenin

其他肿瘤

1.脊索瘤

阳性:PCKEMAS-100

2.内淋巴囊瘤

阳性:PCKEMA

3.嗅神经母细胞瘤

阳性:SynNFMAP2S-100

阴性:CD99

4.小脑血管母细胞瘤

阳性:间质细胞呈S-100NSECD56vimentinInhibin-αD2-40

阴性:EMACD10CAM5.2RCC

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