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在无塑性甲状腺癌中存在不同的血统标记
Wadad S Mneimneh1,2, Sylvia L Asa1
1Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University.
The American journal of surgical pathology
|November 16, 2023
概括
由于生物标志物表达的多样性,对无塑性甲状腺癌 (ATC) 的诊断可能具有挑战性. 这项研究分析了36种ATC,揭示了模仿其他癌症的分歧血统标记,使准确的识别变得复杂.
科学领域:
- 病理学 病理学 病理学
- 在瘤学瘤学.
- 免疫组织化学 免疫组织化学
背景情况:
- 无塑性甲状腺癌 (ATC) 通常是由差异化甲状腺癌 (DTC) 引起的.
- 诊断可能很困难,特别是在有限的活检样本或完全不分化的瘤中,依赖于免疫组织化学标记.
- 在ATC中表达不同的血统标记可以使其诊断和与其他高等级部恶性瘤的差异诊断复杂化.
研究的目的:
- 为了研究形甲状腺癌 (ATC) 的生物标志物概况.
- 为了确定不同的血统标记是否会使ATC的诊断过程复杂化.
- 评估各种免疫组织化学标记在诊断ATC时的有用性.
主要方法:
- 对36例证实或疑似甲状腺发病的ATC病例进行了回顾性分析.
- 对一组包括PAX8,TTF1,BRAFV600E,NRASQ61R,TRK,p53,p40,CDX2,SATB2,GATA3,CD117,CD163,SALL4,SMARCA4,PRAME,SOX10,ERG和HEPPAR在内的标记物进行了免疫组织化学染色.
- 如果有证据表明同时存在或先前存在DTC或明显的甲状腺免疫特征,则将病例纳入.
主要成果:
- 大多数ATC对TTF1是负的,其中13个表达PAX8.
- 突变BRAFV600E和NRASQ61R分别在10/34和12例中呈阳性.
- 观察到GATA3 (11/36),SATB2 (8/36),CD117 (2/35),SALL4 (1/30) 和CD163 (10/30) 的异常表达,同时在5例状形态病例中观察到p40阳性.
结论:
- 无塑性甲状腺癌表现出多种不同的血统标志物.
- 这些异常标志物可以模仿其他瘤,在高度中线部恶性瘤的差异诊断中提出诊断挑战.
- 在临床背景下仔细解释免疫组织化学发现对于准确的ATC诊断至关重要.
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