Department of Pathology and Laboratory Medicine, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI 02903.
Liver Research Center, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI 02903.
Hum Pathol. 2017 Dec;70:62-69. doi: 10.1016/j.humpath.2017.10.010. Epub 2017 Oct 24.
Several markers of pancreatobiliary lineage have been described in the literature. However, none have demonstrated sufficient specificity and sensitivity to warrant diagnostic use. We evaluated the utility of T-complex-associated-testis-expressed 3 (TCTE3) as a pancreatobiliary marker. A set of 247 adenocarcinomas from the gastrointestinal (GI) tract was identified including 18 from the gastroesophageal junction (GEJ), 29 stomach, 17 ampullary, 62 pancreatic, and 16 common bile duct and gallbladder (CBD/GB), 13 non-ampullary small intestine, 32 colon, and 24 rectum. The remainder consisted of 16 cholangiocarcinomas and 20 hepatocellular carcinomas (HCC). Additionally, 163 adenocarcinomas from the breast, gynecologic tract, prostate, urothelium, kidney, and lung were stained for comparison. Immunohistochemistry for TCTE3 and other gastrointestinal markers was performed. Positive expression of TCTE3 was characterized by a strong, well-defined membranous pattern with or without weak cytoplasmic staining. Expression was identified in the normal epithelial cells of pancreatobiliary tree, but staining was absent in normal epithelial cells of esophagus, stomach, and intestine. Hepatocytes, pancreatic acini and islets and other non-epithelial cells were also negative for staining. TCTE3 was expressed in 93.5% of pancreatic ductal adenocarcinomas, 37.5% of CBD/GB adenocarcinomas, 50% of cholangiocarcinomas, 76.4% of ampullary adenocarcinomas, and 33.3% of GEJ adenocarcinomas. Only 3.5% of the gastric, 7.7% of non-ampullary small intestinal and 6.25% of colonic tumors exhibited positive staining. Expression was absent in rectal carcinomas and HCCs. These results suggest that TCTE3 is a useful marker of pancreatobiliary differentiation and may aid in distinguishing these tumors from gastric and intestinal primary tumors.
有几种胰腺胆管谱系标志物已在文献中描述。然而，没有一种标志物具有足够的特异性和敏感性来保证诊断使用。我们评估了 T 复合体相关睾丸表达 3（TCTE3）作为胰腺胆管标志物的效用。一组来自胃肠道（GI）的 247 个腺癌被鉴定出来，包括 18 个来自胃食管交界处（GEJ）、29 个胃、17 个壶腹、62 个胰腺和 16 个胆总管和胆囊（CBD/GB）、13 个非壶腹小肠、32 个结肠和 24 个直肠。其余由 16 个胆管癌和 20 个肝细胞癌（HCC）组成。此外，还对来自乳腺、妇科生殖道、前列腺、尿路上皮、肾脏和肺部的 163 个腺癌进行了染色比较。进行了 TCTE3 和其他胃肠道标志物的免疫组织化学染色。TCTE3 的阳性表达表现为强而明确的膜状模式，伴有或不伴有弱的细胞质染色。在胰腺胆管树的正常上皮细胞中鉴定出表达，但在食管、胃和肠的正常上皮细胞中无染色。肝细胞、胰腺腺泡和胰岛以及其他非上皮细胞也无染色。TCTE3 在 93.5%的胰腺导管腺癌、37.5%的 CBD/GB 腺癌、50%的胆管癌、76.4%的壶腹腺癌和 33.3%的 GEJ 腺癌中表达。仅 3.5%的胃、7.7%的非壶腹小肠和 6.25%的结肠肿瘤显示阳性染色。直肠腺癌和 HCC 中无表达。这些结果表明，TCTE3 是胰腺胆管分化的有用标志物，可帮助区分这些肿瘤与胃和肠原发性肿瘤。
