Differential Diagnosis of Meningeal SFT-HPC and Meningioma Which Immunohistochemical Markers Should Be Used?
Differential Diagnosis of Meningeal SFT-HPC and Meningioma Which Immunohistochemical Markers Should Be Used?
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DOI：
10.1097/pas.0000000000000526
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发表时间：
2016-02-01
影响因子：
5.6
通讯作者：
Bouvier, Corinne
中科院分区：
文献类型：
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作者：
Macagno, Nicolas;Figarella-Branger, Dominique;Bouvier, Corinne
脑膜孤立性纤维瘤-血管外皮细胞瘤(SFT-HPC)和脑膜瘤在组织学检查上很难区分。STAT6免疫组织化学(IHC)是诊断SFT-HPC的可靠标记物。最近，GRIA2也被报道为SFT-HPC的诊断标记物，尽管目前还没有关于脑膜SFT-HPC的广泛数据。这项研究的目的是测试它们在一大群SFT-HPC和脑膜瘤中的诊断性能。在包含76个SFT-HPC和181个脑膜瘤的组织芯片上进行了GRIA2和STAT6的IHC分析。将结果与ALDH1和CD34的先前数据进行比较。检测两种不同的抗STAT6抗体：SC-20多克隆抗体和YE361单抗。96%的脑膜SFT-HPC显示核STAT6阳性，但无脑膜瘤。使用SC-20抗体，在包括脑膜瘤在内的所有病例中，有50%的病例同时观察到STAT6胞浆染色。然而，使用YE361抗体，胞浆染色缺失，核信号强度更强，更好地解释了STAT6 IHC。GRIA2在84%的SFT-HPC和16%的脑膜瘤中呈阳性表达。STAT6具有良好的敏感性(96%)和特异性(100%)，ALDH1和GRIA2的敏感性(84%)相同，但ALDH1和CD34的特异性高于GRIA2(分别为97%和96%对84%)。对于SFT-HPC与脑膜瘤的鉴别诊断，最好的诊断方法是进行STAT6，对于罕见的STAT6阴性病例，其次是ALDH1和CD34。由于脑膜瘤的阳性，GRIA2似乎不太适用于这一适应症。
Meningeal solitary fibrous tumors-hemangiopericytomas (SFT-HPC) and meningiomas can be difficult to distinguish on histologic examination. STAT6 immunohistochemistry (IHC) is a reliable diagnostic marker of SFT-HPCs. Recently, GRIA2 has also been reported to be a diagnostic marker of SFT-HPC, although no extensive data are available for meningeal SFT-HPCs yet. The aim of this study was to test their diagnostic performance in a large cohort of SFT-HPCs and meningiomas. IHC analyses for GRIA2 and STAT6 were performed on tissue microarrays containing 76 SFT-HPCs and 181 meningiomas. Results were compared with previous data with ALDH1 and CD34. Two different anti-STAT6 antibodies were tested: SC-20 polyclonal and YE361 monoclonal antibody. Ninety-six percent of meningeal SFT-HPCs but no meningioma displayed nuclear STAT6 positivity. With SC-20 antibody, concomitant cytoplasmic staining for STAT6 was observed in > 50% of all cases, including meningiomas. However, using YE361 antibody, cytoplasmic staining was absent, and nuclear signal intensity was stronger leading to better interpretation of STAT6 IHC. GRIA2 was positive in 84% of SFT-HPCs and in 16% of meningiomas. STAT6 had excellent sensitivity (96%) and specificity (100%), ALDH1 and GRIA2 had same sensitivity (84%), but ALDH1 and CD34 had better specificity than GRIA2 (97% and 96% vs. 84%, respectively). For the differential diagnosis of SFT-HPCs versus meningiomas, the best diagnostic approach is to perform STAT6, followed by ALDH1 and CD34 in the case of uncommon STAT6-negative cases. Because of meningioma positivity, GRIA2 seems less useful in this indication.