Abstract：
PAX8 plays a role in development of the thyroid, kidney, and the Wolffian and Mullerian tract. In surgical pathology, PAX8 immunohistochemistry is used to determine tumors of renal and ovarian origin, but data on its expression in other tumors are conflicting. To evaluate PAX8 expression in normal and tumor tissues, a tissue microarray containing 17,386 samples from 149 different tumor types and 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. PAX8 results were compared with previously collected data on cadherin 16 (CDH16). PAX8 positivity was found in 40 different tumor types. The highest rate of PAX8 positivity was found in thyroidal neoplasms of follicular origin (98.6-100%), gynecological carcinomas (up to 100%), renal tumors (82.6-97.8%), and urothelial neoplasms (2.3-23.7%). Important tumors with near complete absence of PAX8 staining (< 1%) included all subtypes of breast cancers, hepatocellular carcinomas, gastric, prostatic, pancreatic, and pulmonary adenocarcinomas, neuroendocrine neoplasms, small cell carcinomas of various sites, and lymphomas. High PAX8 expression was associated with low tumor grade in 365 non-invasive papillary urothelial carcinomas (p < 0.0001) but unrelated to patient outcome and/or tumor phenotype in clear cell renal cell carcinoma, high-grade serous ovarian cancer, and endometrioid endometrial carcinoma. For determining a renal tumor origin, sensitivity was 88.1% and specificity 87.2% for PAX8, while sensitivity was 85.3% and specificity 95.7% for CDH16. The combination of PAX8 and CDH16 increased specificity to 96.8%. In conclusion, PAX8 immunohistochemistry is a suitable diagnostic tool. The combination of PAX8 and CDH16 positivity has high specificity for renal cell carcinoma.
摘要：
PAX8在甲状腺的发育中起作用，肾,还有狼犬和穆勒氏区.在外科病理学中，PAX8免疫组织化学用于确定肾脏和卵巢起源的肿瘤，但其在其他肿瘤中的表达数据相互矛盾。为了评估PAX8在正常组织和肿瘤组织中的表达，通过免疫组织化学方法分析了一个组织微阵列,该芯片包含来自149种不同肿瘤类型的17,386个样本和来自76种不同正常组织类型的608个样本.将PAX8结果与先前收集的关于钙粘蛋白16(CDH16)的数据进行比较。在40种不同的肿瘤类型中发现PAX8阳性。在滤泡起源的甲状腺肿瘤中发现PAX8阳性率最高（98.6-100％），妇科癌症（高达100％），肾肿瘤（82.6-97.8％），和尿路上皮肿瘤（2.3-23.7％）。几乎完全没有PAX8染色的重要肿瘤（<1％）包括所有乳腺癌亚型，肝细胞癌，胃,前列腺,胰腺,和肺腺癌，神经内分泌肿瘤,不同部位的小细胞癌，和淋巴瘤。在365例非侵袭性乳头状尿路上皮癌中，PAX8高表达与低肿瘤分级相关（p<0.0001），但与患者预后和/或透明细胞肾细胞癌的肿瘤表型无关。高级别浆液性卵巢癌，子宫内膜样癌。为了确定肾肿瘤的起源，PAX8的敏感性为88.1%,特异性为87.2%,CDH16的敏感性为85.3%,特异性为95.7%.PAX8和CDH16的组合将特异性提高至96.8%。总之,PAX8免疫组织化学是合适的诊断工具。PAX8和CDH16阳性联合对肾细胞癌具有较高的特异性。
