Downes Michelle R, Satturwar Swati, Trudel Dominique, van der Kwast Theo H
Dept of Anantomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Laboratory Medicine Program, University Health Network, Toronto, ON, Canada.
Laboratory Medicine Program, University Health Network, Toronto, ON, Canada; Dept of Pathology and Laboratory Medicine, East Carolina University, NC, United States.
Pathol Res Pract. 2017 Jan;213(1):34-38. doi: 10.1016/j.prp.2016.10.007. Epub 2016 Oct 26.
ERG and PTEN have been suggested as potential prognostic markers in prostatic adenocarcinoma. We assessed the relationship between ERG and PTEN protein expression in cribriform architecture prostatic carcinomas and adjacent acinar non-cribriform carcinoma and determined the interobserver variability in assessment of these markers. A contemporary cohort of radical prostatectomy cases (n=246) were reviewed and cribriform architecture carcinomas (intraductal carcinoma and cribriform Gleason 4 carcinomas) were identified and confirmed with triple cocktail immunostaining. ERG and PTEN protein expression were independently examined across all carcinoma components by two pathologists. 57 cases were available for immunohistochemistry. ERG protein expression was concordant between the cribriform and non-cribriform acinar carcinomas in 56/57 cases. There was no interobserver discrepancy in ERG assessment. PTEN staining was concordant in 53/57 cases however 33 cases showed heterogeneous staining, most marked in the non-cribriform acinar component. The kappa value for interobserver assessment of PTEN scoring was 0.787 (moderate) with discrepant cases resolved by cooperative review. ERG protein expression shows almost complete concordance (98.2%) across cribriform and non-cribriform prostatic carcinomas. Assessment of this staining is straightforward and consistent between observers. PTEN protein expression is heterogeneous and results in only moderate interobserver agreement. Both staining heterogeneity and interpretation present challenges in analyzing PTEN protein expression.
ERG和PTEN已被认为是前列腺腺癌潜在的预后标志物。我们评估了筛状结构前列腺癌和相邻腺泡非筛状癌中ERG与PTEN蛋白表达之间的关系，并确定了观察者间对这些标志物评估的变异性。回顾了一组当代根治性前列腺切除术病例（n = 246），识别出筛状结构癌（导管内癌和筛状Gleason 4级癌），并用三联鸡尾酒免疫染色进行确认。两名病理学家对所有癌成分独立检测ERG和PTEN蛋白表达。57例可用于免疫组织化学检测。56/57例中，筛状和非筛状腺泡癌之间ERG蛋白表达一致。ERG评估中观察者间无差异。53/57例中PTEN染色一致，然而33例显示异质性染色，在非筛状腺泡成分中最为明显。观察者间对PTEN评分评估的kappa值为0.787（中等），通过合作复查解决了有差异的病例。ERG蛋白表达在筛状和非筛状前列腺癌之间显示几乎完全一致（98.2%）。这种染色的评估简单直接，观察者之间一致。PTEN蛋白表达是异质性的，观察者间仅有中等程度的一致性。染色异质性和解读在分析PTEN蛋白表达时都带来了挑战。
