Shah Sejal S, Wu Tsung-Teh, Torbenson Michael S, Chandan Vishal S
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905.
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905.
Hum Pathol. 2017 Jun;64:13-18. doi: 10.1016/j.humpath.2016.12.029. Epub 2017 Jan 13.
CDX2 is a sensitive and specific marker of intestinal differentiation. It is routinely used in surgical pathology, as its expression within a tumor favors an origin within the gastrointestinal tract. We had anecdotally encountered occasional hepatocellular carcinomas (HCCs) that were CDX2 positive. CDX2 expression in HCC has not yet been reported, but it has also not been examined in detail. Therefore, we evaluated CDX2 expression in a large number of resected HCCs. Full tumor sections from 172 resected HCCs and 6 resected fibrolamellar carcinomas (FLCs) were stained for CDX2. Nine (5.2%) of 172 HCCs were positive for CDX2, whereas all 6 FLCs were negative. CDX2 expression in HCCs was more commonly seen in poorly differentiated tumors (5 of 16 cases, 31%) than well and moderately differentiated tumors (4 of 156 cases, 2.5%), P = .0004. No other statistically significant correlations were observed (P>.05). Results of our study show that a small subset (5%) of HCCs can be CDX2 positive. Awareness of this phenomenon is important because CDX2 expression in a liver tumor does not completely exclude a diagnosis of HCC.
CDX2是肠道分化的一种敏感且特异的标志物。它在外科病理学中常规使用，因为其在肿瘤内的表达提示肿瘤起源于胃肠道。我们曾偶然遇到过一些CDX2阳性的肝细胞癌（HCC）。HCC中CDX2的表达尚未见报道，且也未进行过详细研究。因此，我们评估了大量切除的HCC中CDX2的表达。对172例切除的HCC和6例切除的纤维板层癌（FLC）的完整肿瘤切片进行CDX2染色。172例HCC中有9例（5.2%）CDX2呈阳性，而所有6例FLC均为阴性。HCC中CDX2的表达在低分化肿瘤（16例中的5例，31%）中比高分化和中分化肿瘤（156例中的4例，2.5%）中更常见，P = 0.0004。未观察到其他具有统计学意义的相关性（P>0.05）。我们的研究结果表明，一小部分（5%）HCC可以是CDX2阳性。认识到这一现象很重要，因为肝脏肿瘤中CDX2的表达并不能完全排除HCC的诊断。
