Diagnostic immunohistochemistry of neuroblastic tumors

Eighteen commercially available antibodies were applied to formalin-fixed, paraffin-embedded neuroblastomas (NBLs, n = 20), ganglioneuroblastomas (GNBLs, n = 7), and ganglioneuromas (GNs, n = 7) to assess their reliability as markers for neuroendocrine differentiation and degree of tumor cell maturation. Incubations with a monoclonal antibody to neuron-specific enolase resulted in positive reactions in all tumors, with consistently strong staining intensities in moderate and well-differentiated NBLs, GNBLs, and GNs. Antibodies to dopamine beta-hydroxylase and protein gene product (PGP) 9.5 reacted with all tumors except two NBLs. Among the antibodies directed to chromogranins and related proteins, HISL19 was most reliable (33/34) followed by endocrine granule constituent (EGC) (30/34), chromogranin A (LK2H10) (21/34), and chromogranin A + B (CGA + B) (19/34), in proving the existence of endocrine granules in tumor cells and Neurofilament (70 + 200 kD) immunoreactivity was demonstrated in all tumors except two undifferentiated NBLs. S-100 protein-immunoreactive cells were visualized with increasing frequency in highly differentiated GNBLs and GNs, whereas Leu 7 immunoreactivity was restricted to ganglioneuromas. We conclude that antibodies directed to neuron-specific enolase, HISL19, dopamine beta-hydroxylase, neurofilaments, EGC, LK2H10, and leucocyte common antigen represent markers that might be useful in the discrimination of GNBLs from non-neuroendocrine round and small cell tumors in routinely processed tissue. Antibodies to neuron-specific enolase, PGP 9.5, different chromogranins, neurofilaments, vasoactive intestinal peptide (VIP), and S-100 protein may help to determine the grade of tumor cell maturation.