摘要目的:探讨黏蛋白4（MUC4）在脑膜瘤诊断中的应用。方法:收集2011—2017年中国科学技术大学附属第一医院诊断的脑膜瘤258例以及其他中枢神经系统肿瘤165例，使用免疫组织化学检测肿瘤组织MUC4、上皮细胞膜抗原（EMA）、孕激素受体（PR）、SSTR-2蛋白的表达，比较MUC4、EMA、PR、SSTR-2在肿瘤组织中表达的情况。结果:258例脑膜瘤患者中男性85例，女性173例，年龄20~81岁，平均年龄69岁。其中WHO Ⅰ级脑膜瘤192例，WHO Ⅱ级脑膜瘤54例，WHO Ⅲ级脑膜瘤12例。MUC4在脑膜瘤的总表达率为67.8%（175/258），在各型脑膜瘤的阳性率由高到低依次分别为上皮型46/46（100.0%）、分泌型3/3、血管瘤型44/45（97.8%）、不典型37/41（90.2%）、化生型3/4、微囊型2/3、沙砾体型7/11、脊索样型7/11、过渡型14/28（50.0%）、透明细胞型1/2、乳头型1/2、间变型4/9、纤维型7/52（13.5%）、横纹肌样型0/1。PR、EMA、SSTR-2分别在149例（57.7%）、173例（67.1%）、235例（91.1%）脑膜瘤中表达。另外44例EMA阴性脑膜瘤表达MUC4，4例SSTR-2阴性脑膜瘤表达MUC4。在中枢神经系统的其他肿瘤如神经鞘瘤、神经纤维瘤、孤立性纤维性肿瘤/血管外皮瘤（SFT/HPC）、血管母细胞瘤、胶质瘤及室管膜瘤等MUC4均不表达。结论:MUC4广泛表达于脑膜瘤，在脑膜瘤与其他非脑膜上皮来源的中枢神经系统肿瘤的鉴别上具有较大的价值。

abstractsObjective:To investigate the expression of mucin-4 (MUC4) in meningiomas.Methods:Totally 258 cases of meningiomas and 165 cases of other brain tumors were collected from the First Affiliated Hospital of China University of Science and Technology (Anhui Provincial Hospital) from 2011 to 2017. MUC4, EMA, PR, SSTR-2 protein expression was detected by immunohistochemistry, and their expression in meningiomas and other tumor tissue was compared.Results:The 258 patients with meningioma included 85 males and 173 females, with a mean age of 69 years. Among the meningiomas, 192, 54 and 12 were WHO grades Ⅰ, Ⅱ and Ⅲ respectively. The overall expression rate of MUC4 in meningiomas was 67.8% (175/258), including 46/46 (100.0%) in meningothelial meningiomas, 3/3 in secretory meningiomas, 44/45 (97.8%) in angiomatous meningiomas, 37/41 (90.2%) in atypical meningiomas, 3/4 in metaplastic meningiomas, 2/3 in microcystic meningiomas, 7/11 in psammomatous meningiomas, 7/11 in chordoid meningiomas, 14/28 (50.0%) in transitional meningiomas, 1/2 in clear cell meningiomas, 1/2 in papillary meningiomas, 4/9 in anaplastic meningiomas, 7/52 (13.5%) in fibrous meningiomas, and 0/1 in rhabdoid meningiomas. In addition, MUC4 was expressed in 44 EMA negative meningiomas and in four SSTR-2 negative meningiomas. PR, EMA, SSTR-2 were expressed in 149 cases (57.7%), 173 cases (67.1%), 235 cases (91.1%) of meningiomas, respectively. MUC4 was not expressed in other tumors in the central nervous system, including schwannomas, neurofibromas, solitary fibrous tumors/hemangiopericytoma (SFT/HPC), hemangioblastoma, gliomas and ependymomas.Conclusion:MUC4 is widely expressed in meningiomas and has great value in distinguishing meningiomas from other non-meningeal epithelial tumorsof the central nervous system.