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目的探讨在正常胸腺、胸腺瘤、胸腺癌组织中titin抗原决定簇的表达及其与重症肌无力(myasthenia gravis,MG)临床表现的关系。方法选取4例MG伴胸腺瘤患者的胸腺瘤、1例胸腺癌、1例MG伴胸腺瘤患者胸腺瘤旁增生的胸腺组织以及1例正常胸腺组织标本,对所有标本作连续冰冻切片,分别进行HE染色、细胞角蛋白(cytok-eratin,CK)和titin抗原的免疫组化染色,同时测定MG伴胸腺瘤患者血清titin抗体的浓度。结果免疫组化染色结果显示,titin在胸腺瘤中表达呈强阳性,其分布与胸腺瘤上皮细胞的分布一致,胸腺瘤内淋巴细胞和其他结构titin染色呈阴性;在胸腺癌组织内titin染色呈阴性;在正常胸腺中titin染色位于胸腺小体,呈弱阳性,其他结构未见着色。4例MG伴胸腺瘤患者中有3例血清titin抗体阳性。结论 MG伴胸腺瘤患者的胸腺瘤组织中有titin抗原决定簇的表达,且仅表达于胸腺瘤上皮细胞,而正常胸腺组织中titin表达于胸腺小体,提示伴MG的胸腺瘤中发生了免疫微环境的变化。
Objective To investigate the expression of titin epitope in normal thymus, thymoma and thymic carcinoma and its relationship with clinical manifestations of myasthenia gravis (MG). Methods Four thymoma patients with MG with thymoma, one with thymic carcinoma, one with thymoma with thymoma, and one normal thymic tissue were selected. All specimens were frozen frozen and separately performed. HE staining, cytokeratin (CK), and titin antigen immunohistochemical staining were performed to measure serum titin antibody concentrations in MG patients with thymoma. Results Immunohistochemical staining showed that titin was strongly positive in thymoma and its distribution was consistent with the distribution of thymic epithelial cells. Titin staining of thymoma lymphocytes and other structures was negative; titin staining was present in thymic tissue. Negative; in the normal thymus titin staining is located in the thymus, was weakly positive, and no staining was found in other structures. Three of the 4 MG patients with thymomas had positive serum titin antibodies. Conclusions The expression of titin antigenic determinants in thymoma tissues of MG patients with thymoma is expressed only in thymic epithelial cells, whereas titin in normal thymus tissues is expressed in thymus bodies, suggesting that thymoma with MG is immunized Changes in the microenvironment.