Diagnostic Value of Immunohistochemical Markers GATA3, Cyclin D1, KRT20, and GLUT1 in Renal Neoplasms

BackgroundThis study assessed the potential utility of GATA3, cyclin D1, KRT20, and GLUT1 immunohistochemistry (IHC) markers for diagnosing renal epithelial tumors.MethodsA retrospective analysis was conducted on all eligible specimens (n = 95) diagnosed at our institution between 2014 and 2024. IHC was done and the staining intensity and distribution of selected IHC markers were assessed.ResultsAmong 95 specimens, 26% were clear cell renal cell carcinoma, 21% were chromophobe RCC, and 17% were papillary RCC. Less frequent subtypes included TFE3-rearranged RCC, clear cell papillary renal cell tumor (CCPRT), papillary renal neoplasm with reverse polarity (PRNRP), and eosinophilic solid and cystic RCC (ESC-RCC). Clear cell RCC and CCPRT were consistently positive for cyclin D1 and GLUT1, and negative for GATA3/KRT20. CCPRT showed strong, diffuse GLUT1, unlike the limited staining in papillary RCC. PRNRP was positive for GATA3, cyclin D1, and GLUT1, and negative for KRT20. While chromophobe RCC exhibited variable GATA3 and GLUT1 expression with weak to moderate cyclin D1 positivity, oncocytomas were strong cyclin D1 positive, with negative GATA3, KRT20, and GLUT1. All 3 ESC-RCC specimens were KRT20 positive.ConclusionsOur findings validate many previously reported observations and characterize adjunctive patterns of these less commonly used markers across renal tumor subtypes. It suggests GATA3 as a potential diagnostic tool for PRNRP, while GLUT1 demonstrates differential expression patterns for papillary RCC and CCPRT, aiding in distinguishing papillary renal tumors. Similarly, cyclin D1 appears to be a valuable adjunct in differentiating oncocytoma from chromophobe RCC. Also, KRT20 shows high specificity for ESC-RCC.