SALL4在肝母细胞瘤中的诊断和预后价值。

The diagnostic and prognostic value of SALL4 in hepatoblastoma.

作者信息

Zhou Shengmei, Venkatramani Rajkumar, Gomulia Ellen, Shillingford Nick, Wang Larry

机构信息

Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

出版信息

Histopathology. 2016 Nov;69(5):822-830. doi: 10.1111/his.13005. Epub 2016 Jul 25.

DOI:10.1111/his.13005

PMID:27252091

Abstract

AIMS

To investigate the expression of spalt-like transcription factor 4 (SALL4), a regulator of embryonal development, in three epithelial components of hepatoblastoma (HB) and the relationship between SALL4 expression levels and patients' clinicopathological features.

METHODS AND RESULTS

A total of 115 specimens from 79 patients with HB were selected for immunostaining of SALL4. Nuclear staining was semi-quantified using the immunoreactive score (IS; range: 0-12). SALL4 expression was seen in all embryonal components (mean IS = 8.58) and in 41% of fetal components (mean IS = 0.78). No SALL4 expression was seen in either small cell undifferentiated or mesenchymal components of HB. Neither chemotherapy nor metastasis altered SALL4 expression significantly. High SALL4 expression levels were associated significantly with decreased overall survival (OS) (P = 0.004), event-free survival (EFS) (P = 0.003) and the presence of metastasis (P = 0.049) on univariate analysis. Multivariate analysis identified SALL4 as an independent prognostic predictor for OS (P = 0.029).

CONCLUSIONS

SALL4 is useful for subtyping HB, and high SALL4 expression is associated with decreased survival in HB.

摘要

目的

研究胚胎发育调节因子斯帕样转录因子4（SALL4）在肝母细胞瘤（HB）三种上皮成分中的表达情况，以及SALL4表达水平与患者临床病理特征之间的关系。

方法与结果

选取79例HB患者的115份标本进行SALL4免疫染色。采用免疫反应评分（IS；范围：0 - 12）对细胞核染色进行半定量分析。SALL4在所有胚胎成分中均有表达（平均IS = 8.58），在41%的胎儿成分中也有表达（平均IS = 0.78）。在HB的小细胞未分化成分或间充质成分中均未观察到SALL4表达。化疗和转移均未显著改变SALL4的表达。单因素分析显示，高SALL4表达水平与总生存期（OS）降低（P = 0.004）、无事件生存期（EFS）降低（P = 0.003）以及转移的存在（P = 0.049）显著相关。多因素分析确定SALL4是OS的独立预后预测因子（P = 0.029）。