Insulinoma-associated protein 1 (INSM1) is a sensitive and highly specific marker of neuroendocrine differentiation in primary lung neoplasms: an immunohistochemical study of 345 cases, including 292 whole-tissue sections
Insulinoma-associated protein 1 (INSM1) is a sensitive and highly specific marker of neuroendocrine differentiation in primary lung neoplasms: an immunohistochemical study of 345 cases, including 292 whole-tissue sections
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DOI：
10.1038/s41379-018-0122-7
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发表时间：
2019-01-01
期刊：
影响因子：
7.5
通讯作者：
Farver, Carol F.
中科院分区：
文献类型：
--
作者：
Mukhopadhyay, Sanjay;Dermawan, Josephine K.;Farver, Carol F.
最近的证据表明核标记物 INSM1 在神经内分泌肺肿瘤的诊断中发挥作用。本研究的目的是使用大量原发性肺肿瘤的全组织切片来确定 INSM1 作为神经内分泌分化标志物的效用。我们用 INSM1 对 345 个原发性肺肿瘤进行了染色，其中包括 292 个全组织切片。大多数病例还被突触素、嗜铬粒蛋白和 CD56 染色。肿瘤包括 64 例小细胞肺癌、24 例大细胞神经内分泌癌、64 例类癌（48 例典型、16 例非典型）、130 例腺癌和 33 例鳞状细胞癌。对于小细胞肺癌，INSM1 (98%) 的敏感性与突触素 (100%) 和 CD56 (95%) 相似，但显着高于嗜铬粒蛋白 (83%)。对于大细胞神经内分泌癌，CD56（92％）和突触素（88％）比INSM1（75％）更敏感，而嗜铬粒蛋白则不太敏感（46％）。除一种非典型类癌肿瘤（INSM1 呈阴性）外，所有标记物均对 100% 的类癌肿瘤进行染色。 INSM1 对神经内分泌肺肿瘤的敏感性 (95%) 与突触素 (98%) 和 CD56 (97%) 相似，但高于嗜铬粒蛋白 (84%)。 INSM1 对神经内分泌肺肿瘤的特异性 (97%) 与嗜铬粒蛋白 (98%) 相似，但高于突触素 (90%) 和 CD56 (87%)。 INSM1 染色在原发肿瘤和匹配的转移瘤中是一致的。总之，INSM1是原发性肺肿瘤神经内分泌分化的可靠标志物，其敏感性与突触素和CD56相似，特异性与嗜铬粒蛋白相似。
Recent evidence suggests a role for the nuclear marker INSM1 in the diagnosis of neuroendocrine lung neoplasms. The aim of this study was to determine the utility of INSM1 as a marker of neuroendocrine differentiation using a large series of whole-tissue sections of primary lung neoplasms. We stained 345 primary lung neoplasms with INSM1, including 292 whole-tissue sections. Most cases were also stained with synaptophysin, chromogranin, and CD56. The tumors included 64 small cell lung carcinomas, 24 large cell neuroendocrine carcinomas, 64 carcinoid tumors (48 typical, 16 atypical), 130 adenocarcinomas, and 33 squamous cell carcinomas. For small cell lung carcinoma, the sensitivity of INSM1 (98%) was similar to synaptophysin (100%) and CD56 (95%) but considerably higher than chromogranin (83%). For large cell neuroendocrine carcinoma, CD56 (92%) and synaptophysin (88%) were more sensitive than INSM1 (75%), while chromogranin was less sensitive (46%). All markers stained 100% of carcinoid tumors, except one atypical carcinoid tumor, which was negative for INSM1. The sensitivity of INSM1 for neuroendocrine lung neoplasms as a group (95%) was similar to synaptophysin (98%) and CD56 (97%), but higher than chromogranin (84%). The specificity of INSM1 for neuroendocrine lung neoplasms (97%) was similar to chromogranin (98%) but higher than synaptophysin (90%) and CD56 (87%). INSM1 staining was concordant in primary tumors and matched metastases. In conclusion, INSM1 is a reliable marker of neuroendocrine differentiation in primary lung neoplasms, with sensitivity similar to synaptophysin and CD56, and specificity similar to chromogranin.