SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma
SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma
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DOI：
10.1097/pas.0b013e318198177d
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发表时间：
2009-06-01
影响因子：
5.6
通讯作者：
Peng, Yan
中科院分区：
文献类型：
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作者：
Cao, Dengfeng;Guo, Shuangping;Peng, Yan
卵巢原始生殖细胞肿瘤（gct）是一种罕见的肿瘤，有时会给诊断带来挑战。其中卵黄囊肿瘤（YST）诊断难度最大，容易被误认为透明细胞癌（CCC）。目前的免疫组织化学标志物，如甲胎蛋白（AFP），甘聚糖-3。细胞角蛋白（CK） 7和上皮膜抗原（EMA）用于区分YST和CCC缺乏足够的敏感性和特异性。这是免疫组化图。我们在98例gct（29例囊肿，18例生殖细胞异常瘤）中研究了一种新的标记物SALL4。性腺母细胞瘤6例，胚胎癌6例，未成熟畸胎瘤15例，成熟畸胎瘤12例。7例类癌，3例外源性类癌，2例卵巢外源性癌)，特别有兴趣探索SALL4以区分YST和CCC。163个非gct包括45个CCCs也被染色。我们发现SALL4在所有囊肿、生殖异常瘤、性腺母细胞瘤和胚胎癌中90%以上的肿瘤细胞中呈强阳性。15例未成熟畸胎瘤中11例可见可变SALL4染色。本研究纳入的所有其他gct均为SALL4阴性。除3例CCCs局灶性SALL4染色（< 15%肿瘤细胞）外，其余160例非gct中SALL4为阴性。我们还比较了SALL4与AFP、glypican-3、CK7和EMA在所有YSTs和CCCs中的差异。AFP和glypican-3分别在24例（83%）和20例（69%）的YSTs中呈阳性，而16例（35%）和13例（28%）的CCCs分别显示AFP和glypican-3阳性。3例（10%）和4例（14%）YSTs分别显示局灶性（< 21%的肿瘤细胞）CK7和EMA染色。在所有45例CCCs中，CK7和EMA均呈阳性，但分别有3例（7%）和1例（2%）的肿瘤细胞染色低于30%。我们的研究结果表明，SALL4是卵巢原始gct的一种新的敏感和特异性标志物。SALL4在区分YST和CCC方面特别有用，优于AFP。glypican-3、CK7和EMA。
Ovarian primitive germ cell tumors (GCTs) are uncommon tumors and sometimes pose diagnostic challenges. Among them, yolk sac tumor (YST) poses the greatest diagnostic difficulty and can be mistaken for clear cell carcinoma (CCC). Current immunohistochemical markers Such as alpha-fetoprotein (AFP), glypican-3. cytokeratin (CK) 7, and epithelial membrane antigen (EMA) used to distinguish YST from CCC lack adequate sensitivity and specificity. Here by immunohistochemistry. we investigated a novel marker SALL4 in 98 GCTs (29 YSTs, 18 dysgerminomas. 6 gonadoblastomas, 6 embryonal carcinomas, 15 immature and 12 Mature teratomas. 7 carcinoid tumors, 3 strumal carcinoids, and 2 struma ovarii) with particular interest of exploring SALL4 to distinguish YST from CCC. One hundred sixty-three non-GCTs including 45 CCCs were also stained. We found that SALL4 is strongly positive in more than 90% tumor cells in all YSTs, dysgerminomas, gonadoblastomas, and embryonal carcinomas. Variable SALL4 staining is seen in 11 of 15 immature teratomas. All other GCTs included in this Study are negative for SALL4. Except 3 CCCs with focal SALL4 staining (< 15% tumor cells), SALL4 is negative in the remaining 160 non-GCTs. We also compared SALL4 with AFP, glypican-3, CK7, and EMA in all YSTs and CCCs. AFP and glypican-3 are positive in 24 (83%) and 20 (69%) YSTs, respectively, whereas 16 (35%) and 13(28%) CCCs show positive AFP and glypican-3 staining, respectively. Three (10%) and 4 (14%) YSTs show focal (< 21% tumor cells) CK7 and EMA staining, respectively. CK7 and EMA are positive in all 45 CCCs but 3 (7%) and 1 (2%) cases show staining in less than 30% tumor cells, respectively. Our findings indicate that SALL4 is a novel sensitive and specific marker for ovarian primitive GCTs. SALL4 is particularly useful in distinguishing YST from CCC and better than AFP., glypican-3, CK7, and EMA.