多形性腺癌(PAC)是一种罕见的小唾液腺肿瘤。因为它的建筑多样性,PAC的组织学诊断可能很困难,特别是对于小活检,和免疫组织化学是很大的帮助区分它的组织学模拟。这项研究的目的是进行系统的文献综述,以确定可靠的PAC免疫组织化学标记。我们对MEDLINE进行了电子文献检索,ScienceDirect,SpringerLink,和Wiley在线图书馆数据库,涵盖1988年至2021年期间出版的文献。资格标准包括病例报告和PAC病例的回顾性研究以及免疫组织化学标记的详细信息。在搜索和选择过程之后,本系统综述包括32项研究,共409例。总的来说,>90%的阳性观察到的泛细胞角蛋白(CK)(97.3%),CK7(96.8%),CK7/8(97.4%),E-cadherin(90.0%),波形蛋白(92.5%),S100(97.0%),p63(91.7%),SOX10(100%),虽然CK20几乎没有观察到阳性(0.0%),p40(0.0%),和GFAP(5.0%)。平均MIB-1标记指数为3.78%。本系统综述的结果表明,CK7+/CK20-,p63+/p40-,S100+,波形蛋白+,GFAP-免疫表型对PAC有诊断价值。此外,使用S100,MSA,p40和c-Kit提供了有助于区分PAC和腺样囊性癌的额外信息层,具有挑战性的鉴别诊断之一。
Polymorphous adenocarcinoma (PAC) is a rare variant of minor salivary gland tumors. Because of its architectural diversity, histological diagnosis of PAC can be difficult especially for small biopsies, and immunohistochemistry is of great help in differentiating it from its histologic mimics. The aim of this study is to conduct a systematic literature
review to identify reliable immunohistochemical markers for PAC. We conducted an electronic literature search of the MEDLINE, ScienceDirect, SpringerLink, and Wiley Online Library databases, covering the literature published in the period between 1988 and 2021. The eligibility criteria included case reports and retrospective studies of PAC cases with details of immunohistochemical markers. Following the search and selection process, 32 studies with 409 cases were included in this systematic
review. Overall, > 90% positivity was observed for pan-cytokeratin (CK) (97.3%), CK7 (96.8%), CK7/8 (97.4%), E-cadherin (90.0%), Vimentin (92.5%), S100 (97.0%), p63 (91.7%), and SOX10 (100%), while little to no positivity was observed for CK20 (0.0%), p40 (0.0%), and GFAP (5.0%). The average MIB-1 labeling index was 3.78%. The results of this systematic
review indicate that CK7+/CK20-, p63+/p40-, S100+, Vimentin+, and GFAP- immunophenotype have diagnostic value for PAC. In addition, the use of S100, MSA, p40, and c-Kit provide additional layers of information helpful to differentiate PAC from adenoid cystic carcinoma, one of challenging differential diagnoses.