Dual Immunostain With SATB2 and CK20 Differentiates Appendiceal Mucinous Neoplasms From Ovarian Mucinous Neoplasms
Dual Immunostain With SATB2 and CK20 Differentiates Appendiceal Mucinous Neoplasms From Ovarian Mucinous Neoplasms
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DOI：
10.1093/ajcp/aqx023
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发表时间：
2017-05-01
影响因子：
3.5
通讯作者：
Frankel, Wendy L.
中科院分区：
文献类型：
--
作者：
Li, Zaibo;Roth, Rachel;Frankel, Wendy L.
目的：确定腹膜和/或盆腔粘液性肿瘤的原发部位可能具有挑战性，主要鉴别诊断包括腹膜粘液性肿瘤（AMN）和卵巢粘液性肿瘤（OMN）。特殊的AT-丰富的序列结合蛋白2（SATB 2）已被证明是高度选择性地表达在下胃肠道，包括appendic.Methods：我们调查了实用的双重染色（DS）与SATB 2或尾型同源框2（CDX 2）和细胞角蛋白20（CK 20）或绒毛蛋白区分AMNs从OMN。结果：SATB 2单染法对AMNs的敏感性为83%，特异性最高为78%，而对OMNs的敏感性最低为78%。用SATB 2和villin联合诊断的敏感性为78%，特异性为94%，而用SATB 2和CK 20联合诊断的敏感性为80%，特异性为100%。结论：SATB 2/CK 2 0联合DS对AMNs与OMN的鉴别诊断具有最大的潜在临床价值，且优于CDX 2/CK 2 0联合DS，具有上级的诊断价值。重要的是，DS可能有助于组织有限的标本。
Objectives: Determination of the primary site of origin for mucinous neoplasms identified in the peritoneal and/or pelvic cavities may be challenging, with major differential diagnoses including appendiceal mucinous neoplasm (AMN) and ovarian mucinous neoplasm (OMN). Special AT-rich sequence binding protein 2 (SATB2) has been shown to be highly selectively expressed in the lower gastrointestinal tract, including the appendix.Methods: We investigated the utility of a dual stain (DS) with SATB2 or caudal type homeobox 2 (CDX2) and cytokeratin 20 (CK20) or villin in distinguishing AMNs from OMNs. Tissue microarrays with 40 AMNs and 18 OMNs were stained with SATB2 or CDX2 paired with either CK20 or villin.Results: SATB2 single stain showed a good sensitivity of 83% and the highest specificity of 78% for AMNs over OMNs among all four stains. DS with SATB2 and villin showed an identical sensitivity of 78% but specificity increased to 94%, while DS with SATB2 and CK20 showed a sensitivity of 80% and a specificity of 100%. In contrast, DS with CDX2 and CK20/villin showed slightly higher sensitivity but much lower specificity.Conclusions: DS with SATB2/CK20 shows the greatest potential clinical utility in distinguishing AMNs from OMNs and is superior to DS with CDX2/CK20. Importantly, DS could be helpful for specimens with limited tissues.