Dept of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Am J Clin Pathol. 2011 Mar;135(3):454-60. doi: 10.1309/AJCPI8AJLUZ3CZLN.
Currently, the only reliable indicator of malignancy in pheochromocytoma is the presence of distant metastasis or extensive local invasion; predicting behavior of pheochromocytoma remains challenging. We aimed to correlate the behavior of pheochromocytoma with its expression of nm-23, cyclooxygenase (COX)-2, and galectin-3 (genes used to predict the course of some neoplastic diseases), evaluated immunohistochemically in 55 paraffin blocks of formalin-fixed pheochromocytoma specimens with confirmed behavior. In 3 (7%) of 44 benign and 7 (64%) of 11 malignant pheochromocytomas, there was negative nm-23 expression (P = .000). COX-2 immunoreactivity was positive in 10 (23%) of benign and 9 (82%) of malignant tumors (P = .000). Galectin-3 was expressed in 5 (11%) of benign and 9 (82%) of malignant pheochromocytomas (P = .000). Negative nm-23, along with positive COX-2 or galectin-3, predicted malignancy with 100% specificity. Dual negativity for galectin-3 and COX-2, along with nm-23 positivity, indicated benign behavior with 100% sensitivity. In early pheochromocytoma, evaluation of nm-23, galectin-3, and COX-2 expression could predict the outcome. Larger studies seem necessary to confirm the potential practical value of our findings.
目前，嗜铬细胞瘤恶性的唯一可靠指标是远处转移或广泛局部浸润；预测嗜铬细胞瘤的行为仍然具有挑战性。我们旨在将嗜铬细胞瘤的行为与其 nm-23、环氧化酶（COX）-2 和半乳糖凝集素-3（用于预测某些肿瘤疾病过程的基因）的表达相关联，这些基因在 55 个福尔马林固定的嗜铬细胞瘤标本的石蜡块中通过免疫组织化学进行评估，这些标本的行为已得到证实。在 44 例良性和 11 例恶性嗜铬细胞瘤中，有 3 例（7%）nm-23 表达阴性（P =.000）。COX-2 免疫反应性在 10 例良性（23%）和 9 例恶性肿瘤（82%）中为阳性（P =.000）。Galectin-3 在 5 例良性（11%）和 9 例恶性嗜铬细胞瘤中表达（P =.000）。nm-23 阴性，同时 COX-2 或 galectin-3 阳性，预测恶性肿瘤的特异性为 100%。Galectin-3 和 COX-2 双重阴性，同时 nm-23 阳性，预测良性行为的敏感性为 100%。在早期嗜铬细胞瘤中，评估 nm-23、galectin-3 和 COX-2 的表达可以预测结局。似乎需要更大的研究来证实我们研究结果的潜在实际价值。
