net的病理诊断2012天津.ppt

IHC can also test for CgA, which can be detected in the secretory granules of most NET. Similarly to the problem we have with detecting blood levels of CgA in NET of the distal colon and rectum, the IHC for CgA is not sensitive for the large bowel and appendix tumours that secrete CgB since the most commercially available CgA antibodies do not cross-react. ?Reference: Taupenot L, Harper KL, O’Connor DT. N Engl J Med. 2003;348:1134-1149. ? * In contrast to CgA, synaptophysin is expressed independently of secretory granules and therefore useful in identifying poorly granulated and poorly differentiated NET that may not exhibit CgA staining. However, the specificity of this stain is moderate in that synaptophysin staining is not limited to neuroendocrine cells. Reference: Chetty R et al. Arch Pathol Lab Med 2008;132:1285-1289. * 嗜铬蛋白A，突触素，神经元特异性烯醇化酶----角色：组织病理学确认和分类； 作用：确认NET；敏感度：高 Ki-67 抗原----角色：增殖指数；作用：细胞增殖率的评估；敏感度：高 生长抑素受体（亚型1-5）------角色：激素受体；作用：评估生长抑素类似物治疗潜能；敏感度：高 Immunohistochemistry is an important tool for diagnosing NET. It is recommended for the diagnosis in the majority of cases. This technique uses antibodies to detect and visualize antigens in cells and tissues via an immunofluorescence technique, which has largely replaced the immunoenzyme silver-based histochemical stains. The majority of well-differentiated NET express 1 or more neuroendocrine markers. ?Reference: Vinik A, et al. Pancreas. 2009 Nov;38(8):876-89c Several IHC markers are useful for the diagnosis and staging of NET, and some also provide prognostic information. CgA and synaptophysin should be routinely used for histopathological diagnosis and classification of all NET. Other markers, such as the Ki-67 proliferation antigen, are important for determining tumour grade. Staining for somatostatin receptors can indicate whether a patient may be a candidate for treatment with a somatostatin analog. A variety of cytosolic and cell membrane proteins, including neuronspecific enolase (N