双语综述罕见非上皮性卵巢癌病理学，
2017-3-17 来源：不详 浏览次数：次3.ImmunohistochemistryofSCCOHT
3.SCCOHT的免疫组织化学研究
UpuntilrecentlytherewerenospecificimmunohistochemicalmarkersofSCCOHT[9–12].GiventhediscoverythatSMARCA4ismutatedinalmostallcasesofSCCOHT[6],thishasresultedinthedevelopmentofantibodieswhichareusefulindiagnosisandinthedistinctionfromthemanymimics.ThereislossofSMARCA4(BRG1)immunoreactivitysecondarytomutationinalmostallcasesofSCCOHT(Fig.1b),althoughaverysmallminorityexhibitretentionofnuclearimmunoreactivity;occasionaltumoursexhibitlossofSMARCB1(INI1)ratherthanSMARCA4[13,14].Positivestainingofendothelial,stromalandinflammatorycellsactsasapositiveinternalcontrolandthisshouldbepresentbeforeacceptinglossofstaininginthetumourcellsasindicativeofSCCOHT.Althoughtherecanbeheterogeneityofstaininginsomeotherneoplasmsinthedifferentialdiagnosis,thereisusuallyatleastfocalretentionofnuclearimmunoreactivity.SomeovarianclearcellcarcinomasexhibitlossofSMARCA4stainingbutthesedonotenterintothedifferentialdiagnosisofSCCOHT[13,14].AsingleovarianmalignantmelanomahasbeenreportedtoexhibitlossofSMARCA4staining[14].SincethisisaneoplasmwhichmayenterintothedifferentialdiagnosisofSCCOHT,thisrepresentsapotentialdiagnosticpitfall.However,therecentfindingthatduallossofbothSMARCA4(BRG1)andSMARCA2(BRM)proteinexpressionishighlyspecificforSCCOHT[13]shouldmeanthatsuchpitfallscannowbeavoided.
直至最近，尚没有发现SCCOHT特异性免疫组织化学标志物[9-12]。假如所有的SCCOHT病例中均发现SMARCA4发生突变[6]，那么就会引起能够辅助诊断和区分类似病症的抗体的研发。虽然少数保留有核免疫反应性能，但是几乎所有SCCOHT病例中，SMARCA4(BRG1)免疫反应性缺失继发于突变（图1b）；某些卵巢透明细胞癌表现出SMARCA4着色缺失，但是其并不能参与SCCOHT的鉴别诊断[13,14]。据报道，单一的卵巢恶性黑色素瘤也表现为SMARCA4着色缺失[14]。由于其是一种可能参与SCCOHT鉴别诊断的肿瘤，这就存在潜在的诊断陷阱。然而，最近的发现表明，SMARCA4(BRG1)和SMARCA2（BRM）蛋白表达双重缺失是SCCOHT的高特异性[13]，也就是说，目前可以避免这类的诊断错误。
3.1.DifferentialdiagnosisofSCCOHT
3.1SCCOHT的鉴别诊断
SCCOHTistheprototypicalovarianneoplasm专业治疗白癜风的医院哪家好北京白癜风的最好医院
