Boulagnon-Rombi Camille, Fleury Clémence, Fichel Caroline, Lefour Sophie, Marchal Bressenot Aude, Gauchotte Guillaume
Pathology Department, Academic Hospital and Medicine University, Reims, France.
Neurology Department, Academic Hospital, Reims, France.
J Neuropathol Exp Neurol. 2017 Apr 1;76(4):289-298. doi: 10.1093/jnen/nlx008.
The differential diagnosis between meningioma and others tumors can be challenging. This study aimed to evaluate different immunohistochemical markers for the differential diagnosis between meningioma and their morphological mimics. Immunohistochemistry was performed on tissue microarray with antiepithelial membrane antigen (EMA), progesterone receptor, somatostatin receptor 2A (SSTR2A), CD34, STAT6, S100, SOX10, HMB45, MelanA, GFAP, inhibin, and BCL2 antibodies. One hundred and twenty-seven meningiomas, 26 solitary fibrous tumor/hemangiopericytomas (SFT/HPC), 39 schwannomas, 17 hemangioblastomas, 21 melanomas, 9 gliosarcomas, 5 neurofibromas, 9 peripheral primitive neuroectodermal tumors, 7 synovial sarcomas, and 5 malignant peripheral nerve sheath tumors were included in the microarray. SSTR2A was the most sensitive (95.2%) and specific (92%) marker of meningiomas. In combination, SSTR2A and/or EMA positivity reached maximal sensitivity (100%). Coexpression of SSTR2A and EMA was the most specific (94.8%) for the diagnosis of meningioma, regardless of the grade or subtype, with the exception of the differential diagnosis with synovial sarcoma. All synovial sarcomas were EMA-positive and 6/7 SSTR2A-positive. STAT6 showed optimum sensitivity and specificity (100%) for SFT/HPC. SOX10 was the most sensitive (94.3%) and specific (100%) marker to discriminate meningiomas from schwannomas. In conclusion, SSTR2A, STAT6, and SOX10 were the most sensitive and specific markers to distinguish meningiomas from their morphological mimics.
脑膜瘤与其他肿瘤的鉴别诊断可能具有挑战性。本研究旨在评估不同的免疫组化标志物，以用于脑膜瘤与其形态学相似肿瘤的鉴别诊断。采用抗上皮膜抗原（EMA）、孕激素受体、生长抑素受体2A（SSTR2A）、CD34、信号转导和转录激活因子6（STAT6）、S100、SOX10、HMB45、MelanA、胶质纤维酸性蛋白（GFAP）、抑制素和BCL2抗体，对组织芯片进行免疫组化检测。该组织芯片包含127例脑膜瘤、26例孤立性纤维瘤/血管外皮细胞瘤（SFT/HPC）、39例神经鞘瘤、17例血管母细胞瘤、21例黑色素瘤、9例胶质肉瘤、5例神经纤维瘤、9例外周原始神经外胚层肿瘤、7例滑膜肉瘤和5例恶性外周神经鞘瘤。SSTR2A是脑膜瘤最敏感（95.2%）和特异（92%）的标志物。联合使用时，SSTR2A和/或EMA阳性达到最大敏感性（100%）。SSTR2A和EMA的共表达对脑膜瘤的诊断最具特异性（94.8%），无论分级或亚型如何，但与滑膜肉瘤的鉴别诊断除外。所有滑膜肉瘤均为EMA阳性，7例中有6例SSTR2A阳性。STAT6对SFT/HPC显示出最佳的敏感性和特异性（100%）。SOX10是区分脑膜瘤与神经鞘瘤最敏感（94.3%）和特异（100%）的标志物。总之，SSTR2A、STAT6和SOX10是区分脑膜瘤与其形态学相似肿瘤最敏感和特异的标志物。
