Bing Zhanyong, Pasha Theresa, Wang Li-Ping, Zhang Paul J
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Patholog Res Int. 2012;2012:569609. doi: 10.1155/2012/569609. Epub 2012 Jul 10.
Malignant mixed Mullerian tumor (MMMT) is an uncommon aggressive neoplasm composed of both malignant epithelial and mesenchymal components. In this study, immunohistochemical stains of germ cell markers, including SALL4, OCT3/4, glypican-3, and alpha-fetal protein (AFP), and CDX2 were performed in a series of MMMTs. SALL4 nuclear immunoreactivity was detected in 6 out of 19 cases (33%). The staining extent ranged from focal to extensive. The staining intensity was usually intermediate to strong (the score ranged from 1.5 to 3, and average score was 2.3 ± 0.5 in the positive cases). In addition, glypican-3 cytoplasmic reactivity was detected in 14 out of 16 cases (88%) with a mean score of 1.8 ± 0.7 (score ranging from 1 to 3). In contrast, OCT3/4 was only positive in 1 out of 19 cases and AFP in 2 out of 18 cases (11%). In summary, SALL4 and glypican-3 were frequently expressed in a subset of MMMTs. Their roles in the pathogenesis and biology of MMMT are yet to be determined. MMMT should be included in the differential diagnosis when a tumor is positive for SALL4 and/or glypican-3.
恶性苗勒管混合瘤（MMMT）是一种罕见的侵袭性肿瘤，由恶性上皮和间充质成分组成。在本研究中，对一系列MMMT进行了生殖细胞标志物的免疫组化染色，包括SALL4、OCT3/4、磷脂酰肌醇蛋白聚糖-3和甲胎蛋白（AFP），以及CDX2。19例中有6例（33%）检测到SALL4核免疫反应性。染色范围从局灶性到广泛性。染色强度通常为中度至强阳性（评分范围为1.5至3，阳性病例的平均评分为2.3±0.5）。此外，16例中有14例（88%）检测到磷脂酰肌醇蛋白聚糖-3胞质反应性，平均评分为1.8±0.7（评分范围为1至3）。相比之下，19例中只有1例OCT3/4呈阳性，18例中有2例AFP呈阳性（11%）。总之，SALL4和磷脂酰肌醇蛋白聚糖-3在一部分MMMT中频繁表达。它们在MMMT发病机制和生物学中的作用尚待确定。当肿瘤SALL4和/或磷脂酰肌醇蛋白聚糖-3呈阳性时，MMMT应纳入鉴别诊断。
