摘要目的 探讨葡萄糖转运蛋白1(GLUT-1)和结蛋白在胸膜上皮样恶性间皮瘤(EMM)和反应性间皮细胞增生(RMH)中的表达情况及其在辅助胸膜良恶性病变鉴别诊断中的意义.方法 选取胸膜活检组织142例,其中RMH 58例,EMM 53例,另选取胸膜转移性腺癌(MAC)31例作为对照.应用免疫组织化学EliVision法检测GLUT-1及结蛋白在各组病例的表达情况,并分析各组表达差异.结果 GLUT-1在RMH、EMM及MAC中的阳性表达率分别为13.8％(8/58)、81.1％ (43/53)和77.4％ (24/31),恶性病变EMM及MAC组的阳性率均显著高于良性病变RMH组,差异均有统计学意义(均P＜0.01).结蛋白在RMH、EMM及MAC中的阳性表达率分别为77.6％ (45/58)、9.4％(5/53)及0(0/31),RMH组显著高于其余两组,差异均有统计学意义(均P＜0.01).组合分析两抗体,GLUT-1阳性及结蛋白阴性仅见于1例(1.7％,1/58) RMH病例,而见于41例(77.4％,41/53)EMM病例、24例(77.4％,24/31)MAC病例,两抗体的此种组合表达模式在RMH组出现几率显著低于其余两组,差异均有统计学意义(均P＜0.01).结论 GLUT-1和结蛋白在RMH、EMM及MAC中的表达差异可辅助部分良恶性间皮病变的鉴别诊断,组合应用两个抗体具有更高的特异性.

abstractsObjective To investigate the expression of glucose transporter protein 1 (GLUT-1) and desmin in benign and malignant mesothelial lesions,including reactive mesothelial hyperplasia (RMH),epithelioid malignant mesothelioma (EMM) and metastatic adenocarcinoma (MAC).Methods One hundred and forty two pleural biopsy specimens were collected in this study,including 58 cases of RMH,53cases of EMM and 31 cases of MAC.Immunohistochemical EliVision method was performed to detect GLUT-1 and desmin expression.Results The positive rates for GLUT-1 in RMH,EMM and MAC were 13.8％ (8/58),81.1％ (43/53) and 77.4％ (24/31),respectively,with statistically significant differences between RMH and others (both P＜0.01).The positive rates for desmin in RMH,EMM and MAC were 77.6％ (45/58),9.4％ (5/53) and 0 (0/31),respectively,with statistically significant difference between RMH and others (both P ＜ 0.01).The combined expression pattern of positive GLUT-1 and negative desmin was found in 1 (1.7％,1/58) RMH cases,41 (77.4％,41/53) EMM cases and 24 (77.4％,24/31) MAC cases,with statistically significant difference between RMH and others (both P ＜0.01).Conclusions GLUT-1 and desmin may be used as immunohistochemical markers in separating RMH from EMM.Combined application of two antibodies may improve the specificity.