免疫组织化学特征聚类分析表明，CK7、波形蛋白、S100A1 和 C-kit（CD117）可作为鉴别肾嗜酸细胞瘤及其模拟物的最佳组合。
Cluster analysis of immunohistochemical profiles delineates CK7, vimentin, S100A1 and C-kit (CD117) as an optimal panel in the differential diagnosis of renal oncocytoma from its mimics.
机构信息
Department of Pathology, University of Michigan Medical Center, Ann Arbor, MI, USA.
出版信息
Histopathology. 2011 Jan;58(2):169-79. doi: 10.1111/j.1365-2559.2011.03753.x.
AIMS
To develop an immunohistochemical strategy for distinguishing renal oncocytoma (RO) from the eosinophilic variant of chromophobe (ChRCC), and papillary (PRCC) and clear cell (CRCC) renal cell carcinoma containing eosinophilic cytoplasm in core biopsy specimens.
METHODS AND RESULTS
Cluster analysis was performed on immunohistochemical data from 21 RO, 16 ChRCC, 16 CRCC and 20 PRCC patients. A panel of CK7, C-kit, S100A1 and vimentin clustered into four groups. Cluster A (94% ChRCC) expressed C-kit and CK7 and lacked S100A1 and vimentin. Cluster B (95% RO) expressed C-kit, S100A1, focal CK7 (single or small clusters of cells) and lacked vimentin. Cluster C comprised a mixture of PRCC and CRCC with no expression of C-kit or CK7 and variable S100A1 and vimentin. PRCC with strong expression of CK7 clustered into group D. A panel of S100A1 (positive) and focal CK7 expression distinguished RO from ChRCC with 91% sensitivity and 93% specificity. A panel of vimentin (negative) and C-kit (positive) distinguished RO from CRCC with 83% sensitivity and 86% specificity and RO from PRCC with 79% sensitivity and 88% specificity.
CONCLUSIONS
Hierarchical cluster analysis is an effective approach to analyse high-volume immunohistochemical data to generate an optimal panel in the differential diagnosis of oncocytoma from its mimics.
目的
开发一种免疫组织化学策略，以区分肾嗜酸细胞瘤（RO）与嗜酸性嫌色细胞癌（ChRCC）、乳头状（PRCC）和透明细胞（CRCC）肾癌，这些肾癌在核心活检标本中含有嗜酸性细胞质。
方法和结果
对 21 例 RO、16 例 ChRCC、16 例 CRCC 和 20 例 PRCC 患者的免疫组织化学数据进行聚类分析。一组 CK7、C-kit、S100A1 和波形蛋白聚类为四个组。簇 A（94%的 ChRCC）表达 C-kit 和 CK7，缺乏 S100A1 和波形蛋白。簇 B（95%的 RO）表达 C-kit、S100A1、局灶性 CK7（单个或小簇细胞），缺乏波形蛋白。簇 C 由 PRCC 和 CRCC 混合组成，无 C-kit 或 CK7 表达，S100A1 和波形蛋白可变。强表达 CK7 的 PRCC 聚类为组 D。S100A1（阳性）和局灶性 CK7 表达的组合可区分 RO 与 ChRCC，敏感性为 91%，特异性为 93%。波形蛋白（阴性）和 C-kit（阳性）的组合可区分 RO 与 CRCC，敏感性为 83%，特异性为 86%，与 PRCC 的敏感性为 79%，特异性为 88%。
结论
层次聚类分析是一种有效的方法，可以分析大量免疫组织化学数据，以生成最佳组合，用于鉴别嗜酸性细胞瘤与其模拟物的鉴别诊断。
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