PAX8: A Highly Sensitive Marker for the Glands in Extragenital Endometriosis
PAX8: A Highly Sensitive Marker for the Glands in Extragenital Endometriosis
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DOI：
10.1007/s43032-020-00186-7
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发表时间：
2020-05-19
影响因子：
2.9
通讯作者：
Osuga, Yutaka
中科院分区：
文献类型：
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作者：
Arakawa, Tomoko;Fukuda, Shinya;Osuga, Yutaka
在生殖器外子宫内膜异位症或显微镜下子宫内膜异位症病变的情况下，病理诊断可能具有挑战性，因为子宫内膜异位间质和腺体仅代表纤维化子宫内膜异位症病变的一小部分。为了提高诊断的准确性，开发敏感且特异的上皮标记物是有益的。先前的研究表明，PAX8是原发性和转移性苗勒氏管上皮肿瘤的高度敏感和特异性标记物。因此，我们试图检查 PAX8 是否是生殖器外子宫内膜异位症腺体的高度敏感标记。本研究分别评估了 8 个和 47 个卵巢子宫内膜异位症样本和生殖器外子宫内膜异位症样本。我们计算了 PAX8、CD10、雌激素受体 (ER) 和孕激素受体 (PR) 免疫染色呈阳性的样本百分比。在 95.7% (45/47) 的生殖器外子宫内膜异位症和 100% (8/8) 的卵巢子宫内膜异位症中，PAX8 的子宫内膜异位上皮细胞呈阳性。 97.9% (46/47) 的生殖器外子宫内膜异位症中子宫内膜异位症基质细胞 CD10 呈阳性。即使在 CD10 阴性的病例中，PAX8 的腺体也呈强阳性。 PAX8、CD10、PR的表达不受术前激素治疗的影响，ER染色阳性率明显降低。总之，PAX8 是生殖器外子宫内膜异位症的高度敏感的上皮标志物。这种特异性表达在激素治疗下得以维持。值得注意的是，生殖器外子宫内膜异位症虽然发生部位不同，但其发生原因和发生机制可能不同，但仍维持该谱系标志物的表达。 PAX8核表达可用于临床实践中检测生殖器外子宫内膜异位症。
In cases of extragenital endometriosis or microscopic endometriosis lesions, pathological diagnosis can be challenging because endometriotic stroma and glands represent only a minor component of fibrotic endometriotic lesions. For better accuracy of diagnosis, the development of a sensitive and specific epithelial marker is beneficial. Previous studies showed that PAX8 is a highly sensitive and specific marker for primary and metastatic Mullerian epithelial tumors. Therefore, we sought to examine whether PAX8 is a highly sensitive marker for glands in extragenital endometriosis. Eight and 47 samples of ovarian endometrioma and extragenital endometriosis, respectively, were evaluated in this study. We calculated the percentage of samples positively immunostained for PAX8, CD10, estrogen receptor (ER), and progesterone receptor (PR). PAX8 was positive for endometriotic epithelial cells in 95.7% (45/47) of extragenital endometrioses and in 100% (8/8) of ovarian endometrioses. CD10 was positive for endometriotic stromal cells in 97.9% (46/47) of extragenital endometrioses. PAX8 was strongly positive for glands, even in a CD10-negative case. The expression of PAX8, CD10, and PR was not affected by preoperative hormonal therapy, and the positive rate of ER staining was significantly reduced by preoperative hormonal therapy. In conclusion, PAX8 is a highly sensitive epithelial marker for extragenital endometriosis. This specific expression was maintained under hormonal therapy. It is noteworthy that extragenital endometriosis maintains the expression of this lineage marker, although it occurs at various sites, and its cause and mechanism of development might be different. PAX8 nuclear expression can be useful in detecting extragenital endometriosis in clinical practice.