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目的研究脊索瘤的临床病理特点并验证CK、EMA、S-100、vimentin、GFAP、CEA和Ki-67在脊索瘤的免疫组化表达。方法收集82例脊索瘤存档病例,观察其临床特征,并采用EnVision二步法对部分病例行CK、EMA、S-100、vimentin、GFAP、CEA和Ki-67检测。结果①82例脊索瘤患者男女之比为1.17∶1。各年龄段均可发病,发病高峰在41～60岁。好发于中轴骨两端(蝶枕部和骶尾部);易侵犯周围骨和神经,复发多见,多与手术切除不彻底有关。②脊索瘤的组织病理学检查见特征性的液滴状细胞。③CK、EMA、S-100和vimentin的阳性率分别为89%(48/54)、76%(31/41)、81%(47/58)和91%(31/34);GFAP和CEA均(-);Ki-67核阳性指数均<25%(44/44),其中30例核阳性指数<5%(30/44)。结论脊索瘤为少见的低度恶性骨肿瘤,好发于中轴骨两端,局部侵袭性强,易复发。组织病理学上以液滴状细胞为其特征,免疫表型CK、EMA、S-100和vimentin常(+),GFAP和CEA(-)。Ki-67阳性指数低可能与其低度恶性的生物学行为有关。
Objective To investigate the clinicopathological features of chordoma and to verify the immunohistochemical expression of CK, EMA, S-100, vimentin, GFAP, CEA, and Ki-67 in chordoma. Methods Eighty-two cases of chordoma filed were collected and their clinical features were observed. EnVision two-step method was used to detect CK, EMA, S-100, vimentin, GFAP, CEA, and Ki-67 in some cases. Results The ratio of male to female in 182 cases of chordoma was 1.17:1. All ages can be affected, the peak incidence of 41 to 60 years old. Occur in the axial shaft at both ends (butterfly occipital and sacrococcygeal); easy to invade the surrounding bone and nerves, recurrence more common, more and surgical resection is not completely related. 2 Histopathological examination of chordomas showed characteristic droplet-like cells. The positive rates of 3CK, EMA, S-100, and vimentin were 89% (48/54), 76% (31/41), 81% (47/58), and 91% (31/34), respectively; both GFAP and CEA were (-); Ki-67 nuclear positive index <25% (44/44), of which 30 cases of nuclear positive index <5% (30/44). [Conclusion] Chordoma is a rare low-grade bone tumor, which occurs at both ends of the axial shaft, and is highly invasive and easily recurs. Histopathologically characterized by droplet-shaped cells, the immunophenotypes CK, EMA, S-100, and vimentin (+), GFAP and CEA (-). The low Ki-67 positive index may be related to its low-grade biological behavior.