FOS Expression in Osteoid Osteoma and Osteoblastoma A Valuable Ancillary Diagnostic Tool
FOS Expression in Osteoid Osteoma and Osteoblastoma A Valuable Ancillary Diagnostic Tool
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DOI：
10.1097/pas.0000000000001355
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发表时间：
2019-12-01
影响因子：
5.6
通讯作者：
Flanagan, Adrienne M.
中科院分区：
文献类型：
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作者：
Amary, Fernanda;Markert, Eva;Flanagan, Adrienne M.
成骨细胞瘤和骨样骨瘤是最常见的良性骨形成肿瘤，按大小任意分开。在某些情况下，可能很难区分骨母细胞瘤和骨肉瘤。根据我们最近对这些肿瘤中 FOS 基因重排的描述，本研究的目的是评估免疫组织化学在骨样骨瘤、成骨细胞瘤和骨肉瘤中的诊断价值。总共对 337 例病例进行了 c-FOS 抗体检测：84 例成骨细胞瘤、33 例骨样骨瘤、215 例骨肉瘤和 5 例反应性新骨形成样本。总之，83% 的成骨细胞瘤和 73% 的骨样骨瘤在成骨细胞肿瘤细胞成分中显示出 c-FOS 的显着表达。在骨肉瘤中，14% 表现出 c-FOS 表达，通常是局灶性的，并且在具有严重形态异型性且明显恶性的区域中：4% 表现出更明显的表达，但 FOS 基因重排呈阴性。我们得出的结论是，c-FOS 免疫反应性存在于绝大多数成骨细胞瘤/骨样骨瘤中，而其表达通常是局灶性或斑片状的，在不超过 14% 的骨肉瘤活检中表达。因此，任何具有令人担忧的组织学特征的骨形成肿瘤病例都将受益于 FOS 基因重排的荧光原位杂交分析。我们的研究结果强调了根据形态学、临床和放射学特征对抗体表达模式进行彻底评估的重要性。
Osteoblastoma and osteoid osteoma together are the most frequent benign bone-forming tumor, arbitrarily separated by size. In some instances, it can be difficult to differentiate osteoblastoma from osteosarcoma. Following our recent description of FOS gene rearrangement in these tumors, the aim of this study is to evaluate the value of immunohistochemistry in osteoid osteoma, osteoblastoma, and osteosarcoma for diagnostic purposes. A total of 337 cases were tested with antibodies against c-FOS: 84 osteoblastomas, 33 osteoid osteomas, 215 osteosarcomas, and 5 samples of reactive new bone formation. In all, 83% of osteoblastomas and 73% of osteoid osteoma showed significant expression of c-FOS in the osteoblastic tumor cell component. Of the osteosarcomas, 14% showed c-FOS expression, usually focal, and in areas with severe morphologic atypia which were unequivocally malignant: 4% showed more conspicuous expression, but these were negative for FOS gene rearrangement. We conclude that c-FOS immunoreactivity is present in the vast majority of osteoblastoma/osteoid osteoma, whereas its expression is usually focal or patchy, in no more than 14% of osteosarcoma biopsies. Therefore, any bone-forming tumor cases with worrying histologic features would benefit from fluorescence in situ hybridization analysis for FOS gene rearrangement. Our findings highlight the importance of undertaking a thorough assessment of expression patterns of antibodies in the light of morphologic, clinical, and radiologic features.