目的:子宫内膜或卵巢的中肾样腺癌(MLA)是一种罕见但独特的子宫内膜癌,具有特征性的形态学组合,免疫组织化学(IHC)和分子特征。SOX17最近已被确定为子宫内膜癌和卵巢癌的高度敏感和特异性标志物。在这项研究中,我们旨在研究SOX17在MLA和其他IHC中的表达,以区分MLA和其他子宫内膜癌.
方法:收集17个先前诊断的子宫内膜/卵巢MLAs,并进行了多个IHC。此外,我们在2012年至2015年MLA诊断标准未建立时,对652例子宫内膜癌组成的组织微阵列(TMA)进行了SOX17,PAX8和ER检测.
结果:所有17个MLA均显示弥漫性强阳性PAX8,阴性ER和可变的TTF1/GATA3染色。值得注意的是,所有MLA均显示SOX17阴性(n=10)或局灶性弱/中度(n=7)染色,在其他子宫内膜癌亚型中,SOX17比PAX8更弥漫性和更强。这一发现促使我们通过结合SOX17和PAX8IHC的方法筛选出在MLA之前诊断为652例子宫内膜癌的TMA,14例PAX8阳性但SOX17阴性/局灶性弱。我们通过检查形态学和进行其他IHC(TTF1,GATA3,ER和CD10)进一步研究了14例病例,并根据形态学特征和阳性CD10,TTF1和/或GATA3染色将其中7例(50%)分类为MLA。
结论:我们的结果表明,如果结果显示PAX8强阳性,但SOX17阴性,SOX17和PAX8IHC的组合将有助于诊断MLA。
OBJECTIVE: Mesonephric-like adenocarcinoma (MLA) of the endometrium or ovary is a rare but distinct endometrial carcinoma which has a combination of characteristic morphological, immunohistochemical (IHC) and molecular features.
SOX17 has been recently identified as a highly sensitive and specific marker for endometrial and ovarian carcinomas. In this study, we aimed to investigate
SOX17 expression in MLA together with other IHCs to differentiate MLAs from other endometrial carcinomas.
METHODS: Seventeen previously diagnosed endometrial/ovarian MLAs were collected, and multiple IHCs were performed. Additionally, we performed
SOX17, PAX8 and ER on tissue microarrays (TMAs) composed of 652 endometrial carcinomas from 2012 to 2015 when MLA diagnostic criteria were not established.
RESULTS: All 17 MLAs showed diffuse strong positive PAX8, negative ER and variable TTF1/GATA3 staining. Notably, all MLAs showed negative (n = 10) or focal weak/moderate (n = 7) staining for SOX17, which is more diffuse and stronger than PAX8 in other endometrial carcinoma subtypes. This finding prompted us to screen TMAs with 652 endometrial carcinomas diagnosed before MLA by an approach of combined SOX17 and PAX8 IHCs, and 14 cases with positive PAX8 but negative/focal weak
SOX17 were identified. We further studied the 14 cases by examining morphology and performing additional IHCs (TTF1, GATA3, ER and CD10) and would classify seven (50%) of them as MLAs based on morphological features and positive CD10, TTF1 and/or GATA3 staining.
CONCLUSIONS: Our results suggest that a combination of SOX17 and PAX8 IHCs would aid in diagnosing MLA if the results show strong positive PAX8, but negative
SOX17.