A Comparison of GATA3, TTF1, CD10, and Calretinin in Identifying Mesonephric and Mesonephric-like Carcinomas of the Gynecologic Tract
A Comparison of GATA3, TTF1, CD10, and Calretinin in Identifying Mesonephric and Mesonephric-like Carcinomas of the Gynecologic Tract
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DOI：
10.1097/pas.0000000000001142
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发表时间：
2018-12-01
影响因子：
5.6
通讯作者：
Hoang, Lynn
中科院分区：
文献类型：
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作者：
Pors, Jennifer;Cheng, Angela;Hoang, Lynn
妇科中肾癌是一种因其形态多样而常被忽视的肿瘤。最近，GATA3和TTF1被报道为区分中肾癌及其形态模拟物的有用免疫组织化学标记物。在此，我们将GATA3和TTF1与用于中肾癌的传统标志物CD10和calretinin的性能进行了比较。我们研究了694例：8例系肾癌（7例宫颈[包括3例系肾癌肉瘤]，1例阴道），5例系肾样癌（4例子宫体，1例卵巢），585例子宫内膜腺癌，96例宫颈腺癌。中肾样癌被定义为表现出中肾癌的典型形态特征，但发生在子宫颈外且没有令人信服的中肾残余的肿瘤。与TTF1（45%和99%）、CD10（73%和83%）和calretinin（36%和89%）相比，GATA3具有最高的敏感性和特异性（91%和94%）。然而，GATA3也能对大量子宫癌肉瘤进行染色（23/ 113,20 %）。TTF1在5/5（100%）的间肾样癌中呈阳性，而只有1/8（13%）的间肾癌呈阳性。在4/6（67%）的TTF1阳性病例中，GATA3呈现与TTF1相反的染色模式。综上所述，GATA3是中肾癌和中肾癌样癌的最佳整体标志物，但不能用于区分中肾癌肉瘤和米勒氏癌肉瘤。GATA3和TTF1之间的反向染色模式表明，当怀疑中肾或中肾样癌的小活检中GATA3呈阴性时，TTF1可能有用。在中肾样癌中较高的TTF1阳性表明它们可能在生物学上不同于典型的中肾癌。
Mesonephric carcinomas of the gynecologic tract are neoplasms that are often under-recognized due to their varied morphologic appearances. Recently, GATA3 and TTF1 have been reported to be useful immunohistochemical markers for distinguishing mesonephric carcinomas from its morphologic mimics. Herein, we compared the performance of GATA3 and TTF1 to the traditional markers used for mesonephric carcinomas, CD10 and calretinin. We studied 694 cases: 8 mesonephric carcinomas (7 cervical [includes 3 mesonephric carcinosarcomas], 1 vaginal), 5 mesonephric-like carcinomas (4 uterine corpus, 1 ovarian), 585 endometrial adenocarcinomas, and 96 cervical adenocarcinomas. Mesonephric-like carcinomas were defined as tumors exhibiting the classic morphologic features of mesonephric carcinoma, but occurring outside of the cervix and without convincing mesonephric remnants. GATA3 had the highest sensitivity and specificity (91% and 94%) compared with TTF1 (45% and 99%), CD10 (73% and 83%), and calretinin (36% and 89%). GATA3, however, also stained a substantial number of uterine carcinosarcomas (23/113, 20%). TTF1 was positive in 5/5 (100%) mesonephric-like carcinomas and only 1/8 (13%) mesonephric carcinomas. In 4/6 (67%) TTF1 positive cases, GATA3 exhibited an inverse staining pattern with TTF1. In summary, GATA3 was the best overall marker for mesonephric and mesonephric-like carcinomas, but cannot be used to distinguish mesonephric carcinosarcomas from Mullerian carcinosarcomas. The inverse staining pattern between GATA3 and TTF1, suggests that TTF1 may be useful when GATA3 is negative in small biopsies where mesonephric or mesonephric-like carcinoma is suspected. The greater TTF1 positivity in mesonephric-like carcinomas suggests they may be biologically different from prototypical mesonephric carcinomas.