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碳酸酐酶 IX、α-甲基酰基辅酶 A 消旋酶、细胞角蛋白 7 和半乳糖凝集素-3 在肾肿瘤评估中的作用:组织微阵列免疫组织化学研究。

Role of carbonic anhydrase IX, α-methylacyl coenzyme a racemase, cytokeratin 7, and galectin-3 in the evaluation of renal neoplasms: a tissue microarray immunohistochemical study.

机构信息

Department of Pathology and Laboratory Medicine, Hospital of University of Pennsylvania, Philadelphia, 19104, USA.

出版信息

Ann Diagn Pathol. 2013 Feb;17(1):58-62. doi: 10.1016/j.anndiagpath.2012.07.002. Epub 2012 Aug 14.

Abstract

Kidney tumors of various types may behave differently and have different prognosis. Because of some overlapping morphological features and immunohistochemical staining pattern, they may pose diagnostic challenge. Therefore, it is necessary to explore additional immunohistochemical stains to help classifying these epithelial neoplasms. Tissue microarrays of 20 cases each of renal cell carcinomas of clear cell, chromophobe, and papillary variants and oncocytoma were constructed and used to test a panel of immunohistochemical markers including carbonic anhydrase IX, galectin-3, cytokeratin 7 (CK7), and α-methylacyl coenzyme a racemase. Carbonic anhydrase IX was highly sensitive for clear cell renal cell carcinoma (90% positivity) and was negative in all other renal epithelial tumors except for 1 chromophobe renal cell carcinoma (chRCC). Expression of galectin-3 was found mostly in renal tumors with oncocytic features, including oncocytomas (100%) and chRCCs (89%). α-Methylacyl coenzyme a racemase was positive in papillary renal cell carcinoma (100%). CK7 was positive in papillary renal cell carcinoma (90%), chRCC (89%), and oncocytoma (90%). Although both chRCC and oncocytoma were positive for CK7, but with a different patterns, CK7 staining in chRCC was diffuse, whereas it was sporadic in oncocytoma. Panel of carbonic anhydrase IX, galectin-3, CK7, and α-methylacyl coenzyme a racemase is sensitive and specific for the differential diagnosis of the renal epithelial tumors.

摘要

各种类型的肾脏肿瘤可能表现不同,预后也不同。由于某些重叠的形态学特征和免疫组织化学染色模式,它们可能会带来诊断上的挑战。因此,有必要探索额外的免疫组织化学染色来帮助这些上皮性肿瘤的分类。构建了 20 例每个的透明细胞肾细胞癌、嫌色细胞肾细胞癌和乳头状变体以及嗜酸细胞瘤的组织微阵列,并用于测试一组包括碳酸酐酶 IX、半乳糖凝集素-3、细胞角蛋白 7(CK7)和α-甲基酰基辅酶 A 消旋酶的免疫组织化学标志物。碳酸酐酶 IX 对透明细胞肾细胞癌具有高度敏感性(阳性率为 90%),除 1 例嫌色细胞肾细胞癌(chRCC)外,在所有其他肾上皮肿瘤中均为阴性。半乳糖凝集素-3 的表达主要见于具有嗜酸细胞特征的肾肿瘤,包括嗜酸细胞瘤(100%)和 chRCCs(89%)。α-甲基酰基辅酶 A 消旋酶在乳头状肾细胞癌中阳性(100%)。CK7 在乳头状肾细胞癌(90%)、chRCC(89%)和嗜酸细胞瘤(90%)中阳性。虽然 chRCC 和嗜酸细胞瘤均对 CK7 阳性,但模式不同,chRCC 中的 CK7 染色为弥漫性,而嗜酸细胞瘤中则为散在性。碳酸酐酶 IX、半乳糖凝集素-3、CK7 和α-甲基酰基辅酶 A 消旋酶的组合对肾上皮性肿瘤的鉴别诊断具有敏感性和特异性。

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