Tong Guo-Xia, Chiriboga Luis, Hamele-Bena Diane, Borczuk Alain C
Department of Pathology, Columbia University Medical Center, New York, NY 10032, USA.
Mod Pathol. 2007 Aug;20(8):856-63. doi: 10.1038/modpathol.3800827. Epub 2007 May 25.
PAX2 is a urogenital developmental transcription factor expressed in the Wolffian ducts, developing kidneys, and Müllerian ducts during embryonic stage. Its function in renal development is well documented and its clinical application in the diagnosis of lesions of renal origin has been reported recently. However, information on its role in the Müllerian-derived genital tract is sparse. In this study, we investigated the expression of PAX2 in human female genital tract using immunohistochemistry. We demonstrated that PAX2 was expressed specifically in the epithelial cells of fallopian tube, endometrial and endocervical glands, but not in the stromal tissues in these areas. PAX2 was detected in secondary Müllerian structures in the ovary, such as endometriotic and endosalpingiotic glands and rete ovarii, but not in ovarian surface epithelium, surface epithelium-derived inclusion cysts, stroma, or sex-cord-derived structures such as follicles, oocytes, and corpus luteum. In addition, PAX2 was detected in 67% of ovarian papillary serous carcinomas (N=36) but rarely in peritoneal malignant mesotheliomas, with two exceptions (N=54). Interestingly, the two PAX2-positive 'peritoneal malignant mesotheliomas' were from female patients and were positive for estrogen receptor. The significance of expression of PAX2 and estrogen receptor in these cases is under investigation. Taken together, we suggest that PAX2 is a novel Müllerian-specific epithelial marker when used in proper clinical settings. Identification of PAX2 in the majority of papillary serous carcinomas of the ovary but not in the ovarian surface epithelium or epithelium-derived inclusion cysts suggests that this malignant epithelial tumor may be directly derived from the primary or secondary Müllerian epithelium in or surrounding the ovary, rather than from the surface epithelium or its derivatives.
PAX2是一种泌尿生殖系统发育转录因子，在胚胎期的中肾管、发育中的肾脏和苗勒管中表达。其在肾脏发育中的功能已有充分记录，并且最近报道了其在肾源性病变诊断中的临床应用。然而，关于其在苗勒管源性生殖道中的作用的信息却很少。在本研究中，我们使用免疫组织化学方法研究了PAX2在人类女性生殖道中的表达。我们发现PAX2特异性表达于输卵管、子宫内膜和宫颈内膜腺体的上皮细胞中，而在这些区域的间质组织中不表达。在卵巢的继发性苗勒管结构中检测到PAX2，如子宫内膜异位症和输卵管内膜异位症腺体以及卵巢网，但在卵巢表面上皮、表面上皮衍生的包涵囊肿、间质或卵泡、卵母细胞和黄体等性索衍生结构中未检测到。此外，在67%的卵巢乳头状浆液性癌（N = 36）中检测到PAX2，但在腹膜恶性间皮瘤中很少见，仅有两例例外（N = 54）。有趣的是，这两例PAX2阳性的“腹膜恶性间皮瘤”来自女性患者，且雌激素受体呈阳性。这些病例中PAX2和雌激素受体表达的意义正在研究中。综上所述，我们认为在适当的临床环境中，PAX2是一种新的苗勒管特异性上皮标志物。在大多数卵巢乳头状浆液性癌中检测到PAX2，而在卵巢表面上皮或上皮衍生的包涵囊肿中未检测到，这表明这种恶性上皮性肿瘤可能直接来源于卵巢内或周围的原发性或继发性苗勒管上皮，而非表面上皮或其衍生物。
