摘要目的 探讨D2-40和annexin-1两种抗体标记室管膜来源肿瘤的情况及诊断意义。方法 收集宣武医院病理科2005年至2009年52例室管膜来源肿瘤，包括48例室管膜肿瘤（4例黏液乳头型室管膜瘤，38例室管膜瘤，6例间变型室管膜瘤），4例脉络丛乳头状瘤，以10例非肿瘤性脑组织作为对照。应用EnVision二步法进行免疫组织化学染色，观察D2-40、annexin-1、上皮细胞膜抗原( EMA)和Ki-67的表达情况。结果 D2-40在室管膜肿瘤总的阳性率为32/48( 66.7％)，其中21/38(55.3％)的室管膜瘤和5/6的间变型室管膜瘤可见特异性结构即点状(dot-like)或环状(ringlike)结构。室管膜肿瘤D2-40标记阳性等级与Ki-67阳性指数之间无相关性(r=-0.013，P=0.931)。annexin-1在室管膜肿瘤总的阳性率为87.5％ (42/48)，1/4的黏液乳头型室管膜瘤、28.9％(11/38)的室管膜瘤出现特异性的颗粒状结构（granular structure）或室管膜上皮刷状缘。室管膜肿瘤annexin-1标记阳性等级与Ki-67阳性指数之间有相关性（r=-0.405,P=0.005）。D2-40、EMA和annexin-1三种抗体联合诊断室管膜肿瘤阳性率为100％。脉络丛乳头状瘤的D2-40和annexin-1标记均呈阳性。对照组D2-40完全阴性，annexin-1细胞背景阴性，小血管壁阳性。结论 D2-40和annexin-1在室管膜来源肿瘤中表达阳性率高，尤其是特异性结构的出现具有较高的诊断价值。D2-40和annexin-1联合EMA的免疫组织化学标记是诊断室管膜来源肿瘤的有效方法。

abstractsObjective To investigate the diagnostic significance of D2-40 and annexin-1 in the ependymal tumors. Methods To analyses the expression of D2-40, annexin-1, EMA and Ki-67 by immunohistochemistry in 52 cases of ependymal tumors (48 cases of ependymomas, 4 cases of choroid plexus papilloma) from Xuanwu Hospital from 2005 to 2009. Ten cases of corresponding normal brain tissue were also obtained as control. Results Thirty-two of forty-eight ( 66. 7％ ) cases of ependymomas were positive for D2-40. “ Dot-like” and “ring-like” structures were commonly observed in ependymomas (55. 3％ ,21 of 38 cases) and anaplastic ependymomas (5 of 6 cases) with D2-40 staining. There was no difference in the expression between D2-40 and Ki-67 (r, =-0. 013 ,P =0. 931 ). For annexin-1 , 87.5％(42 of 48 cases) of the ependymomas were positive. The specific “granular structures” and cilium were observed in ependymomas ( 1 of 4 cases of myxopapillary ependymomas and 11 of 38 cases of ependymomas respectively) for annexin-1. The difference in expression between annexin-1 and Ki-67 was statistically significant (r =-0. 405 ,P =0. 005). D2-40 in combination of EMA and annexin-1 increased the positive rate to 100％ in ependymomas. Choroid plexus papillomas were all positive for D2-40 and annexin-l. The control tissue was negative for D2-40 but positive for annexin-1 in the capillaries. Conclusions The specific structures are valuable in diagnosing of ependymal-genetic tumors, and are highlighted by D2-40 and annexin-1. D2-40 in combination of EMA and annexin-1 is a useful diagnostic marker for ependymal tumors.