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A Next-generation Tissue Microarray ngTMA Protocol for Biomarker Studies
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Tissue microarray based immunohistochemical study of TLE1 in synovial sarcoma and its histologic mimics
Sumitra Sivakoti1, Shantveer G Uppin2, Megha S Uppin2
1Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad; Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India.
Indian Journal of Pathology & Microbiology
|April 14, 2021
Summary
TLE1 is a highly sensitive immunohistochemical marker for diagnosing synovial sarcoma (SS), showing positivity in 96.4% of cases. While specific, awareness of TLE1 expression in other tumors is crucial to prevent misdiagnosis.
Area of Science:
- Oncology
- Pathology
- Molecular Diagnostics
Background:
- Molecular analysis is the gold standard for synovial sarcoma (SS) diagnosis but faces practical limitations.
- Immunohistochemical markers, such as TLE1, are explored as alternatives.
- Previous studies on TLE1 for SS diagnosis have yielded conflicting results.
Purpose of the Study:
- To evaluate the immunohistochemical expression of TLE1 in synovial sarcoma (SS).
- To assess the utility of TLE1 in differentiating SS from its histological mimics.
Main Methods:
- A tissue microarray was constructed from 63 cases (28 SS, 35 mimics).
- Immunohistochemical staining for TLE1 was performed on all cases.
- Nuclear immunoreactivity was graded based on intensity and cellular percentage.
Main Results:
- TLE1 was expressed in 96.4% of synovial sarcoma cases.
- High TLE1 positivity was observed across various SS subtypes (monophasic, biphasic, poorly differentiated, calcifying).
- TLE1 expression was also detected in some histological mimics, including GISTs, haemangiopericytoma, schwannomas, and mesenchymal chondrosarcoma.
Conclusions:
- TLE1 demonstrates high sensitivity for diagnosing synovial sarcoma (SS).
- TLE1 exhibits reasonable specificity for SS, but cross-reactivity in other tumors necessitates caution.
- Understanding TLE1 expression patterns in non-SS tumors is vital for accurate diagnosis and avoiding misclassification.
