PPARγ staining as a surrogate for PAX8/PPARγ fusion oncogene expression in follicular neoplasms:: Clinicopathological correlation and histopathological diagnostic value
PPARγ staining as a surrogate for PAX8/PPARγ fusion oncogene expression in follicular neoplasms:: Clinicopathological correlation and histopathological diagnostic value
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DOI：
10.1210/jc.2004-1203
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发表时间：
2005-01-01
影响因子：
5.8
通讯作者：
McIver, B
中科院分区：
文献类型：
--
作者：
Sahin, M;Allard, BL;McIver, B
PAX 8/PPARgamma（PPFP）融合癌基因对滤泡性甲状腺癌（FTC）具有中度特异性。目前尚不清楚这是否可以转化为改进的诊断，分类，或预后prediction.We研究了一组特征良好的滤泡性腺瘤（FA），FTC，和Hurthle细胞癌（HCC）患者的完整的临床随访，以确定是否PPARgamma免疫组织化学（作为PAX 8/PPARgamma表达的替代物）有助于区分FA和FTC，并评估其作为冷冻切片的辅助诊断准确性。我们还将PPARgamma染色与临床结果相关联，以评估其作为预后标志物的作用。PPARgamma染色在FTC（54例中的31例; 57%）中比HCC（23例中的1例; 4%）或FA（31例中的4例; 13%）更常见（P <0.00001）。辅助使用PPAR γ免疫组化使术中冰冻切片诊断的敏感性从84%提高到96%（P < 0.05），但特异性从100%降低到90%（P < 0.05）。PPARgamma染色与有利的预后指标（女性、更好的肿瘤分化和更低的转移风险）相关。PPARgamma染色可能有助于FA、FTC和HCC的鉴别诊断，特别是当组织形态学的诊断灵敏度降低时（例如在术中冷冻切片期间）。过氧化物酶体增殖物激活受体γ染色也显示与良好的预后相关，并可能在危险分层中发挥作用。
The PAX8/PPARgamma (PPFP) fusion-oncogene is moderately specific for follicular thyroid carcinomas (FTC). It remains unknown whether this can be translated into improved diagnosis, classification, or outcome prediction.We studied a cohort of well-characterized follicular adenomas (FA), FTC, and Hurthle cell carcinomas (HCC) from patients with complete clinical follow-up, to determine whether PPARgamma immunohistochemistry (as a surrogate of PAX8/PPARgamma expression) helps to distinguish FA from FTC and to assess its diagnostic accuracy as an adjunct to frozen section. We also correlated PPARgamma staining with clinical outcomes to assess its role as a prognostic marker.PPARgamma staining was more common in FTC (31 of 54; 57%) than in HCC (one of 23; 4%) or FA (four of 31; 13%) (P < 0.000001). Adjunctive use of PPAR gamma immunohistochemistry improved diagnostic sensitivity of intraoperative frozen section from 84% to 96% (P < 0.05) but reduced specificity from 100% to 90% (P < 0.05). PPAR gamma staining was associated with favorable prognostic indicators (female gender, better tumor differentiation, and lesser risk of metastases).PPAR gamma staining may be helpful in the differential diagnosis of FA, FTC, and HCC, particularly when diagnostic sensitivity of histomorphology is reduced (e.g. during intraoperative frozen section). PPAR gamma staining also shows an association with favorable prognosis and may have a role in risk stratification.