Tjarks Brian J, Pownell Brandy R, Evans Claire, Thompson Paul A, Kerkvliet Amy M, Koch Michael R D, Jassim Ali D
Department of Pathology, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota.
Sanford Research, Sioux Falls, South Dakota.
J Cutan Pathol. 2018 Jan;45(1):1-7. doi: 10.1111/cup.13037. Epub 2017 Sep 19.
Reliable nuclear immunohistochemical stains for sebaceous neoplasms have not been readily available. Positive nuclear staining has been reported for GATA3 and factor XIIIa (AC-1A1). We sought to determine the diagnostic utility of these nuclear stains by comparing their staining pattern to adipophilin, a consistently positive cytoplasmic stain.
Cases with the diagnosis of sebaceous hyperplasia, sebaceous adenoma, sebaceous epithelioma/sebaceoma, sebaceous carcinoma, and nonsebaceous neoplasms (basal cell carcinoma and squamous cell carcinoma) were examined. Intensity and extent of staining of the basal cells and mature sebocytes were evaluated for each stain.
Factor XIIIa (AC-1A1) was 87.3% sensitive and 95.1% specific for all sebaceous neoplasms sand showed high inter-observer reliability. Adipophilin was 83.2% sensitive and 87.8% specific. GATA3 was the least sensitive (80.9%) and specific (75.6%) marker. When factor XIIIa was compared against composite staining of all three markers its staining was still uniquely significant (P = .0210).
Factor XIIIa (AC-1A1) is a sensitive and specific nuclear marker for sebaceous differentiation. Its diagnostic utility exceeds that of adipophilin. Factor XIIIa should be included in the expanding group of immunohistochemical and special stains which can be utilized to aid in the diagnosis of sebaceous neoplasms.
用于皮脂腺肿瘤的可靠的核免疫组化染色方法尚未普及。已有报道称GATA3和因子ⅩⅢa（AC-1A1）呈核阳性染色。我们试图通过将这些核染色的模式与亲脂素（一种始终呈阳性的胞质染色）进行比较，来确定这些核染色的诊断效用。
对诊断为皮脂腺增生、皮脂腺腺瘤、皮脂腺上皮瘤/皮脂腺瘤、皮脂腺癌以及非皮脂腺肿瘤（基底细胞癌和鳞状细胞癌）的病例进行检查。评估每种染色中基底细胞和成熟皮脂腺细胞的染色强度和范围。
因子ⅩⅢa（AC-1A1）对所有皮脂腺肿瘤的敏感性为87.3%，特异性为95.1%，且观察者间可靠性高。亲脂素的敏感性为83.2%，特异性为87.8%。GATA3是敏感性（80.9%）和特异性（75.6%）最低的标志物。当将因子ⅩⅢa与所有三种标志物的复合染色进行比较时，其染色仍然具有独特的显著性（P = 0.0210）。
因子ⅩⅢa（AC-1A1）是皮脂腺分化的一种敏感且特异的核标志物。其诊断效用超过亲脂素。因子ⅩⅢa应纳入可用于辅助皮脂腺肿瘤诊断的不断扩大的免疫组化和特殊染色组中。
