Huang Qiong, Chen Xiaoduan, Lu Weiguo, Lai Maode, Lu Bingjian
Departments of *Pathology & Pathophysiology †Surgical Pathology ‡Gynecologic Oncology, The Affiliated Women's Hospital, School of Medicine, Zhejiang University, Zhejiang Province, P.R. China.
Appl Immunohistochem Mol Morphol. 2014 Apr;22(4):295-301. doi: 10.1097/PAI.0b013e3182936d8e.
Regenerating islet-deprived gene family, number 4 (REG4), is a novel marker for intestinal differentiation. We performed immunohistochemical studies on REG4, cytokeratin (CK)7, CK20, and caudal type homeobox 2 (CDX2) in 291 ovarian mucinous tumors. There were 226 primary tumors and 65 metastatic tumors. The primary tumors comprised 69/226 mucinous cystadenomas, 79/226 mucinous borderline tumors (64/79 intestinal-type and 15/79 endocervical-like tumors), and 78/226 mucinous carcinomas. We found that REG4 expression was significantly higher in mucinous borderline tumors (30/79, 38.0%) and primary mucinous carcinomas (26/78, 33.3%) than in mucinous cystadenomas (4/69, 5.8%; P<0.05). However, REG4 expression was more commonly associated with intestinal-type, borderline, mucinous tumors rather than the endocervical-like type (30/64 vs. 0/15, P<0.001). There was a significant correlation between the REG4 and CDX2 expression profiles in primary ovarian mucinous tumors (r=0.772, P<0.001). REG4, CDX2, and diffuse CK20 had higher expression frequencies in metastatic lower gastrointestinal adenocarcinoma than in primary mucinous tumors (P<0.01). The CK7/REG4 coordinate expression profile was comparable in diagnostic value to CK7/CK20 or CK7/CDX2 profile. We conclude that REG4 expression is common in mucinous borderline tumors of the intestinal type as it is absent in the endocervical-like form in this series. Expression of CK7/REG4 may contribute to the differential diagnosis between primary and metastatic ovarian mucinous tumors.
再生胰岛衍生基因家族4（REG4）是一种肠道分化的新型标志物。我们对291例卵巢黏液性肿瘤进行了REG4、细胞角蛋白（CK）7、CK20和尾型同源盒2（CDX2）的免疫组织化学研究。其中有226例原发性肿瘤和65例转移性肿瘤。原发性肿瘤包括69/226例黏液性囊腺瘤、79/226例黏液性交界性肿瘤（64/79例肠型和15/79例宫颈内膜样肿瘤）以及78/226例黏液性癌。我们发现，REG4在黏液性交界性肿瘤（30/79，38.0%）和原发性黏液性癌（26/78，33.3%）中的表达显著高于黏液性囊腺瘤（4/69，5.8%；P<0.05）。然而，REG4表达更常见于肠型、交界性黏液性肿瘤，而非宫颈内膜样类型（30/64 vs. 0/15，P<0.001）。原发性卵巢黏液性肿瘤中REG4和CDX2的表达谱之间存在显著相关性（r=0.772，P<0.001）。REG4、CDX2和弥漫性CK20在转移性下消化道腺癌中的表达频率高于原发性黏液性肿瘤（P<0.01）。CK7/REG4协同表达谱在诊断价值上与CK7/CK20或CK7/CDX2谱相当。我们得出结论，REG4表达在本系列中肠型黏液性交界性肿瘤中常见，而在宫颈内膜样类型中不存在。CK7/REG4的表达可能有助于原发性和转移性卵巢黏液性肿瘤的鉴别诊断。
