Busca Aurelia, Gulavita Previn, Parra-Herran Carlos, Islam Shahidul
Department of Pathology and Laboratory Medicine, University of Ottawa and The Ottawa Hospital (A.B., S.I.) Department of Medical Biology, University of Ottawa and Montfort Hospital (P.G.), Ottawa Department of Laboratory Medicine and Pathobiology, University of Toronto and Sunnybrook Health Sciences Centre, Toronto (C.P.H.), ON, Canada.
Int J Gynecol Pathol. 2018 Jul;37(4):372-378. doi: 10.1097/PGP.0000000000000424.
Distinguishing between uterine neoplasms of smooth muscle and endometrial stromal origin is a frequent diagnostic challenge. We investigated the staining pattern of interferon-induced transmembrane protein-1 (IFITM1), a novel endometrial stromal marker, in endometrial and smooth muscle uterine neoplasms and compared it with CD10 in its ability to differentiate between these two groups. Immunohistochemistry for IFITM1 and CD10 was performed in 20 cases of smooth muscle neoplasms (10 cases leiomyoma, 10 cases leiomyosarcoma), 14 cases of endometrial stromal sarcoma (ESS) (12 cases of low grade and 2 cases of high grade) and 12 cases of carcinosarcoma. Staining was scored in terms of intensity and distribution (0=absent, 1=weak/<50%, 2=moderate/50%-75%, 3=strong/>75%). A total score was obtained by adding intensity and distribution scores and classified as positive (score 3-6) or negative (score 0-2). IFITM1 was positive in 10 of 12 (83%) low-grade ESSs, 6 of 20 (30%) smooth muscle tumors (leiomyomas and leiomyosarcomas) and 11 of 12 carcinosarcomas (91.6%). The 2 cases of high-grade ESS were IFITM1 negative. While both IFITM1 (83%) and CD10 (91%) had high sensitivity in differentiating low-grade ESSs from smooth muscle neoplasms, IFITM1 (70%) had higher specificity compared with CD10 (45%). In this study IFITM1 appears to be a more specific marker of endometrial stromal differentiation compared with CD10 in differentiating low-grade ESSs from smooth muscle neoplasms. Thus, IFITM1 may be a valuable tool as part of an immunohistochemical evaluation panel in this diagnostic scenario.
区分平滑肌来源和子宫内膜间质来源的子宫肿瘤是常见的诊断挑战。我们研究了一种新型子宫内膜间质标志物——干扰素诱导跨膜蛋白-1（IFITM1）在子宫内膜和子宫平滑肌肿瘤中的染色模式，并将其与CD10区分这两组肿瘤的能力进行比较。对20例平滑肌肿瘤（10例平滑肌瘤、10例平滑肌肉瘤）、14例子宫内膜间质肉瘤（ESS）（12例低级别、2例高级别）和12例癌肉瘤进行IFITM1和CD10免疫组织化学检测。根据染色强度和分布进行评分（0=无，1=弱/<50%，2=中度/50%-75%，3=强/>75%）。将强度和分布评分相加得到总分，分为阳性（评分3-6）或阴性（评分0-2）。12例低级别ESS中有10例（83%）IFITM1呈阳性，20例平滑肌肿瘤（平滑肌瘤和平滑肌肉瘤）中有6例（30%）呈阳性，12例癌肉瘤中有11例（91.6%）呈阳性。2例高级别ESS的IFITM1为阴性。虽然IFITM1（83%）和CD10（91%）在区分低级别ESS与平滑肌肿瘤方面均具有高敏感性，但与CD10（45%）相比，IFITM1（70%）具有更高的特异性。在本研究中，与CD10相比，在区分低级别ESS与平滑肌肿瘤方面，IFITM1似乎是更具特异性的子宫内膜间质分化标志物。因此，在这种诊断情况下，IFITM1作为免疫组织化学评估组的一部分可能是一种有价值的工具。
