CD10(+) and CK7/RON(-) Cell Carcinoma, Conventional Type With Eosinophilic Morphology From its Mimickers
CD10(+) and CK7/RON(-) Cell Carcinoma, Conventional Type With Eosinophilic Morphology From its Mimickers
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DOI：
10.1097/pai.0b013e31823fecd3
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发表时间：
2012-10-01
影响因子：
1.6
通讯作者：
Jorda, Merce
中科院分区：
文献类型：
--
作者：
Yasir, Saba;Herrera, Loren;Jorda, Merce
背景资料：肾细胞癌常规（透明细胞）类型与嗜酸性形态（ccRCC），嫌色肾细胞癌嗜酸性变体（chRCC）和肾嗜酸细胞瘤（RO）之间的区别是一个常见的诊断难题。我们的目的是确定一个免疫组化面板区分ccRCC从其形态mimics.Materials和方法：五十三肾肿瘤（19 ccRCC，18 chRCC，和16 RO）被选中。CD 10、细胞角蛋白7（CK 7）、c-Kit、E-钙粘蛋白、N-钙粘蛋白、肾特异性钙粘蛋白的免疫组织化学染色Ksp-钙粘蛋白（Ksp-cadherin）和原核受体（罗恩）。19例ccRCC中10例（53%）CD 10阳性，11例（58%）E-钙粘蛋白阳性，8例（42%）N-钙粘蛋白阳性，5例（26%）Ksp-钙粘蛋白阳性，9例（47%）罗恩阳性，6例（32%）CK 7阳性，c-Kit阳性5例（26%）。在chRCC/RO组中，5/34例（15%）CD 10阳性，32/32例（94%）E-cadherin阳性，2/34例（6%）N-cadherin阳性，1/34例（3%）Ksp-cadherin阳性，22/32例（65%）罗恩阳性，14/34例（41%）CK 7阳性，25/32例（76%）c-kit阳性。单变量，阴性c-Kit [比值比（OR）= 8.75，P = 0.001，受试者工作特征曲线下面积（AUC）= 0.747]，阴性E-钙粘蛋白（OR = 11.64，P = 0.005，AUC = 0.681），N-cadherin阳性（OR = 11.64，P = 0.005，AUC = 0.681），Ksp-钙粘蛋白阳性（OR = 11.79，P = 0.031，AUC = 0.617）和阳性⑶ 10（OR = 6.44，P = 0.005，AUC = 0.690）检测ccRCC相对于chRCC/RO。多因素分析显示，当CK 7阴性时，CD 10阳性与ccRCC（OR = 16.90，P = 0.007）和罗恩阴性与ccRCC（OR = 7.17，P = 0.047）之间存在显著相关性。结论：ccRCC的最佳单一预测因子是c-Kit阴性、E-cadherin阴性、N-cadherin阳性、Ksp-cadherin阳性和CD 10阳性。然而，考虑到所研究的标志物，阳性CD 10和阴性CK 7和罗恩的组合被认为是区分ccRCC与chRCC/RO的最佳免疫组化组。
Background: The distinction between renal cell carcinoma conventional (clear cell) type with eosinophilic morphology (ccRCC), chromophobe renal cell carcinoma eosinophilic variant (chRCC), and renal oncocytoma (RO) is a common diagnostic dilemma. We aimed to identify an immunohistochemical panel to discriminate ccRCC from its morphologic mimics.Materials and Methods: Fifty-three renal neoplasms (19 ccRCC, 18 chRCC, and 16 RO) were selected. Immunohistochemical stains for CD10, cytokeratin 7 (CK7), c-Kit, E-cadherin, N-cadherin, kidney-specific cadherin (Ksp-cadherin), and Recepteur d'origine nantais (RON) were performed.Results: Ten (53%) of 19 ccRCC were positive for CD10, 11 (58%) for E-cadherin, 8 (42%) for N-cadherin, 5 (26%) for Ksp-cadherin, 9 (47%) for RON, 6 (32%) for CK7, and 5 (26%) for c-Kit. In chRCC/RO group, 5 of 34 (15%) were positive for CD10, 32 (94%) for E-cadherin, 2 (6%) for N-cadherin, 1 (3%) for Ksp-cadherin, 22 (65%) for RON, 14 (41%) for CK7, and 25 (25/32, 76%) for c-kit. Univariately, negative c-Kit [odds ratio (OR) = 8.75, P = 0.001, area under the receiver operating characteristic curve (AUC) = 0.747], negative E-cadherin (OR = 11.64, P = 0.005, AUC = 0.681), positive N-cadherin (OR = 11.64, P = 0.005, AUC = 0.681), positive Ksp-cadherin (OR = 11.79, P = 0.031, AUC = 0.617), and positive CD10 (OR = 6.44, P = 0.005, AUC = 0.690) detects ccRCC versus chRCC/RO. Multivariate analysis showed significant association between CD10 positivity and ccRCC (OR = 16.90, P = 0.007) and between RON negativity and ccRCC (OR = 7.17, P = 0.047) when CK7 is negative.Conclusions: The best single predictors for ccRCC are negative c-Kit, negative E-cadherin, positive N-cadherin, positive Ksp-cadherin, and positive CD10. However, considering the studied markers, a combination of positive CD10 and negative CK7 and RON is considered the best immunohistochemical panel in distinguishing ccRCC from chRCC/RO.