Nelson Emily R, Sharma Rajni, Argani Pedram, Cimino-Mathews Ashley
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA.
Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA; Department of Oncology, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA.
Hum Pathol. 2017 Sep;67:205-210. doi: 10.1016/j.humpath.2017.08.011. Epub 2017 Aug 23.
Sox10 labeling by immunohistochemistry has been primarily reported in tumors of neural crest origin, such as nerve sheath tumors and melanoma. However, Sox10 also labels primary breast carcinomas, particularly those with the basal-like, triple-negative phenotype. However, the utility of Sox10 labeling in metastatic breast carcinomas has not been reported. Here, we prospectively evaluated Sox10 labeling in surgically resected metastatic breast carcinomas from 26 patients sampled on tissue microarrays. In this cohort, Sox10 labeling was seen in 3 metastatic breast carcinomas (12%), all of which were grade III, triple-negative ductal carcinomas metastatic to the brain (n=2) or lung (n=1). Overall, 38% of triple-negative metastases were Sox10 positive, compared to 0% of estrogen receptor (ER) or human epidermal growth factor 2 (HER-2) metastases (P=.045). In addition, we retrospectively reviewed the use of Sox10 immunohistochemistry in metastatic carcinomas in our clinical practice. We identified 21 cases from January 2012-July 2017 in which Sox10 immunohistochemistry was ordered on clinical sign-out in the work-up of a metastatic carcinoma as being of possible breast origin. Overall, Sox10 labeled 57% (n=12) of all evaluated metastatic carcinomas. All of the Sox10 tumors were ER, such that 71% of ER carcinomas were Sox10 in comparison to 0% of ER carcinomas (P=0.049). In conclusion, the differential diagnosis of a Sox10 malignancy of unknown origin should not be limited to metastatic melanoma. Sox10 labeling is seen in a subset of metastatic triple-negative breast carcinomas, supporting its use as a marker of breast origin in this setting.
免疫组织化学检测Sox10标记主要见于神经嵴来源的肿瘤,如神经鞘瘤和黑色素瘤。然而,Sox10也标记原发性乳腺癌,尤其是那些具有基底样、三阴性表型的乳腺癌。然而,Sox10标记在转移性乳腺癌中的应用尚未见报道。在此,我们前瞻性评估了26例手术切除的转移性乳腺癌组织微阵列样本中Sox10的标记情况。在这一队列中,3例转移性乳腺癌(12%)可见Sox10标记,所有这些均为III级、转移至脑(n = 2)或肺(n = 1)的三阴性导管癌。总体而言,38%的三阴性转移灶Sox10呈阳性,而雌激素受体(ER)或人表皮生长因子2(HER-2)转移灶为0%(P = 0.045)。此外,我们回顾性分析了我们临床实践中Sox10免疫组化在转移性癌中的应用情况。我们确定了2012年1月至2017年7月间的21例病例,这些病例在转移性癌的检查中因临床签出而进行Sox10免疫组化检查,怀疑可能起源于乳腺。总体而言,Sox10标记了所有评估的转移性癌的57%(n = 12)。所有Sox10阳性肿瘤均为ER阴性,因此71%的ER阴性癌为Sox10阳性,而ER阳性癌为0%(P = 0.049)。总之,对来源不明的Sox10恶性肿瘤进行鉴别诊断时不应局限于转移性黑色素瘤。在一部分转移性三阴性乳腺癌中可见Sox10标记,支持其在这种情况下作为乳腺来源标志物的应用。