病理診断に有用な特殊染色

Special Stains Useful for Diagnosis of Colon Tumors

要旨　大腸腫瘍の病理診断において免疫染色を含む特殊染色が用いられてきた．静脈侵襲とリンパ管侵襲を調べるために，それぞれElastica van GiesonまたはVictoria blue-HE染色とD2-40免疫染色が最近しばしば用いられている．腫瘍の粘膜下層浸潤距離の測定にはDesmin免疫染色が用いられる．腺腫や鋸歯状病変といった前癌病変と腺癌，あるいは潰瘍性大腸炎関連腫瘍の鑑別診断には，Ki-67やp53蛋白に対する免疫染色が有用である．内分泌細胞腫瘍の形質判定や悪性度の推定，あるいは転移性と原発性の鑑別にも免疫染色が用いられる．病理診断には肉眼診断とHE切片による組織診断が重要であるが，特殊染色を用いてより客観的で再現性のある病理診断を提供したい．

　Special stains including IHC（immunohistochemical）stains have been applied for the pathological diagnosis of colon tumors. Elastica van Gieson or Victoria Blue-HE stains, and D2-40 IHC are often used to detect venous involvement and lymphatic permeation respectively. Desmin-IHC is used to measure the depth of tumor invasion in the submucosal layer. IHC with Ki67 and p53 proteins is useful for making a differential diagnosis among premalignant lesions, adenocarcinoma and ulcerative-colitis related neoplasms. Phenotyping and evaluating the malignant nature of endocrine tumor, or differentially diagnosing metastatic from primary tumors, IHC is also applied. We pathologists would like to provide more objective and reproducible data using special stains, in addition to routine macroscopic and microscopic studies.