TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms
TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms
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DOI：
10.1038/modpathol.2009.47
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发表时间：
2009-07-01
期刊：
影响因子：
7.5
通讯作者：
Folpe, Andrew L.
中科院分区：
文献类型：
--
作者：
Kosemehmetoglu, Kemal;Vrana, Julie A.;Folpe, Andrew L.
TLE 1是造血、神经元分化和终末上皮细胞分化所必需的转录抑制因子，最近在单个组织芯片研究中显示其是滑膜肉瘤的高度敏感和相对特异的标志物。然而，尚未在软组织和骨肿瘤的标准切片中研究TLE 1的表达。我们研究了TLE 1在大量特征明确的间叶肿瘤中的表达，以更全面地描述TLE 1表达的范围。使用Dako Dual Envision +检测系统对163例骨和软组织肿瘤的标准切片进行TLE 1免疫染色（sc-9121，1：100;圣克鲁斯生化公司）。核阳性评分为阴性（50%的细胞为阳性）。总体而言，TLE 1在20例滑膜肉瘤中的18例（90%）中表达，其中16例（89%）显示2-3个垂直条阳性。然而，在143例（37%）非滑膜肉瘤中也观察到TLE 1表达，其中36例（25%）显示2-3 +阳性。TLE 1在周围神经鞘瘤中的表达最常见，包括33%的神经纤维瘤、100%的神经鞘瘤和30%的恶性周围神经鞘瘤。在非肿瘤组织中，细胞核TLE 1表达在基底角质形成细胞、脂肪细胞、神经束膜细胞、内皮细胞和间皮细胞中存在差异。我们的研究证实了TLE 1对滑膜肉瘤的极好敏感性。然而，TLE 1表达绝不是滑膜肉瘤特异性的，存在于许多进入其鉴别诊断的肿瘤中，特别是外周神经鞘起源的肿瘤。TLE 1表达的异质性可能解释了本标准切片研究与早期TMA研究之间的差异。TLE 1在滑膜肉瘤的鉴别诊断中可能有价值，但应仅在一组抗体的情况下使用。形态学，辅助免疫组化的传统标志物，如细胞角蛋白和CD 34，和滑膜肉瘤相关融合基因的分子确认应该仍然是这种诊断的“金标准”。现代病理学（2009）22，872-878; doi：10.1038/modpathol.2009.47;在线发表2009年4月10日
TLE1, a transcriptional repressor essential in hematopoiesis, neuronal differentiation and terminal epithelial differentiation, has recently been shown in a single tissue microarray study to be a highly sensitive and relatively specific marker of synovial sarcomas. Expression of TLE1 has not, however, been studied in standard sections of soft tissue and bone tumors. We investigated TLE1 expression in a large series of well-characterized mesenchymal tumors, to more fully characterize the range of TLE1 expression. Standard sections of 163 bone and soft tissue tumors were immunostained for TLE1 (sc-9121, 1: 100; Santa Cruz Biochemicals) using the Dako Dual Envision + detection system. Nuclear positivity was scored as negative (50% of cells positive). Overall, TLE1 was expressed by 18 of 20 (90%) of synovial sarcoma, with 16 cases (89%) showing 2-3 vertical bar positivity. However, TLE1 expression was also seen in 53 of 143 (37%) non-synovial sarcoma, with 36 such cases (25%) showing 2-3 + positivity. TLE1 expression was commonly seen in peripheral nerve sheath tumors, including 33% of neurofibromas, 100% of schwannomas, and 30% of malignant peripheral nerve sheath tumors. Among non-neoplastic tissues, nuclear TLE1 expression was variably present in basal keratinocytes, adipocytes, perineurial cells, endothelial cells and mesothelial cells. Our study confirms the excellent sensitivity of TLE1 for synovial sarcoma. However, TLE1 expression is by no means specific for synovial sarcoma, being present in a number of tumors, which enter its differential diagnosis, in particular tumors of peripheral nerve sheath origin. Heterogeneity of TLE1 expression likely explains the differences between the present standard section study and the earlier TMA study. TLE1 may be of value in the differential diagnosis of synovial sarcoma, but should be used only in the context of a panel of antibodies. Morphology, ancillary immunohistochemistry for traditional markers such as cytokeratins and CD34, and molecular confirmation of synovial sarcoma-associated fusion genes should remain the 'gold standards' for this diagnosis. Modern Pathology (2009) 22, 872-878; doi: 10.1038/modpathol.2009.47; published online 10 April 2009