Naeem Namra, Mushtaq Sajid, Akhter Noreen, Hussain Mudassar, Hassan Usman
Department of Histopathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore.
J Coll Physicians Surg Pak. 2018 May;28(5):352-356. doi: 10.29271/jcpsp.2018.05.352.
To ascertain the effectiveness of IHC markers of vascular origin like CD31, CD34, FLI1 and ERG in vascular soft tissue sarcomas including angiosarcomas, Kaposi sarcomas, epithelioid hemangioendothelioma and a non-vascular soft tissue sarcoma (Epithelioid sarcoma).
Descriptive study.
Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from 2011 to 2017.
Diagnosed cases of angiosarcomas (n=48), epithelioid hemangioendothelioma (n=9), Kaposi sarcoma (n=9) and epithelioid sarcoma (n=20) were selected. Immunohistochemical staining as performed on formalin fixed paraffin embedded sections. The sections were stained for the following markers: CD34 (VENTANA clone Q Bend 10), CD31 (Leica clone 1 A 10), FLI1 (CELL MARQUE clone MRQ-1) and ERG (CELL MARQUE clone EP111).
A complete panel of CD34, CD31 and ERG was applied on 8/48 cases of angiosarcomas with triple positivity in 6 cases. Eight cases showed positivity for only CD31 and ERG and 2 cases showed positivity for only ERG. A complete panel of CD34, CD31 and ERG was applied on 3/9 cases of epithelioid hemangioendothelioma with positivity for all markers in 2 cases. Combined positivity for ERG and CD34 was seen in 2 cases and on 4 cases only CD31 immunohistochemical was solely applied with 100% positivity. FLI1 was not applied on any case. Among 9 cases of Kaposi sarcoma, ERG, CD34 and CD31 in combination were applied on only 1 case with triple positivity. Remaining cases show positivity for either CD34, CD31 or FLI1. Majority of cases of epithelioid sarcomas were diagnosed on the basis of cytokeratin and CD34 positivity with loss of INI1. The other vascular markers showed negativity in all cases.
Among these four markers, ERG immunohistochemical stain is highly effective for endothelial differentiation due to its specific nuclear staining pattern in normal blood vessel endothelial cells (internal control) as well as neoplastic cells of vascular tumors and lack of background staining.
确定血管源性免疫组化标志物如CD31、CD34、FLI1和ERG在血管软组织肉瘤（包括血管肉瘤、卡波西肉瘤、上皮样血管内皮瘤）及一种非血管软组织肉瘤（上皮样肉瘤）中的有效性。
描述性研究。
拉合尔的沙卡特汗姆纪念癌症医院及研究中心，2011年至2017年。
选取诊断为血管肉瘤（n = 48）、上皮样血管内皮瘤（n = 9）、卡波西肉瘤（n = 9）和上皮样肉瘤（n = 20）的病例。对福尔马林固定石蜡包埋切片进行免疫组织化学染色。切片针对以下标志物进行染色：CD34（VENTANA克隆Q Bend 10）、CD31（徕卡克隆1 A 10）、FLI1（CELL MARQUE克隆MRQ - 1）和ERG（CELL MARQUE克隆EP111）。
对48例血管肉瘤中的8例应用了完整的CD34、CD31和ERG检测，其中6例呈三联阳性。8例仅CD31和ERG呈阳性，2例仅ERG呈阳性。对9例上皮样血管内皮瘤中的3例应用了完整的CD34、CD31和ERG检测，2例所有标志物均呈阳性。2例可见ERG和CD34联合阳性，4例仅应用了CD31免疫组化检测且阳性率为100%。未对任何病例应用FLI1检测。在9例卡波西肉瘤中，仅1例联合应用了ERG、CD34和CD31且呈三联阳性。其余病例CD34、CD31或FLI1呈阳性。大多数上皮样肉瘤病例根据细胞角蛋白和CD34阳性以及INI1缺失进行诊断。其他血管标志物在所有病例中均呈阴性。
在这四种标志物中，ERG免疫组化染色因其在正常血管内皮细胞（内部对照）以及血管肿瘤的肿瘤细胞中具有特定的核染色模式且无背景染色，对内皮分化具有高度有效性。
