Agustina Hasrayati, Asyifa Ita, Aziz Afiati, Hernowo Bethy S
Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia.
Patholog Res Int. 2018 May 3;2018:6346409. doi: 10.1155/2018/6346409. eCollection 2018.
The diagnosis of Osteosarcoma (OSA) is not always straightforward. OSA may resemble Other Primary Bone Tumours (OPBT). The diagnosis of osteosarcoma is sometimes difficult especially in a very small specimen. Immunohistochemistry is one of ancillary testing types that can help the diagnosis of many tumours. The aim of this study was to evaluate the validity of Osteocalcin (OCN) and Alkaline Phosphatase (ALP) immunohistochemistry in discriminating OSA from OPBT.
This study included 50 selected human primary bone tumours, 25 cases of OSA and 25 cases of OPBT. Immunohistochemical evaluation of OCN and ALP was done for all cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated.
The mean age of OSA and OPBT patients was 19.6 ± 13.6 and 40.0 ± 16.3 years, respectively. Osteocalcin was positive in 17/25 (68%) cases of OSA and 16/25 (64%) cases of OPBT ( = 0.061). Alkaline Phosphatase was positive in 24/25 (96%) cases of OSA and 5/25 (20%) cases of OPBT ( < 0.001). The sensitivity of OCN in OSA diagnosis was 68%, with specificity, PPV, NPV, and overall accuracy being 36%, 52%, 53%, and 52%, respectively. The sensitivity of ALP in OSA diagnosis was 96%, with specificity, PPV, NPV, and overall accuracy being 80%, 82.7%, 95.2%, and 88%, respectively.
ALP immunohistochemistry is useful in discriminating OSA from OPBT. ALP is superior to OCN in OSA diagnosis. OCN cannot be used to differentiate between OSA and OPBT.
骨肉瘤（OSA）的诊断并非总是一目了然。骨肉瘤可能与其他原发性骨肿瘤（OPBT）相似。骨肉瘤的诊断有时很困难，尤其是在非常小的标本中。免疫组织化学是有助于许多肿瘤诊断的辅助检测类型之一。本研究的目的是评估骨钙素（OCN）和碱性磷酸酶（ALP）免疫组织化学在区分骨肉瘤与其他原发性骨肿瘤中的有效性。
本研究纳入了50例选定的人类原发性骨肿瘤，其中25例骨肉瘤和25例其他原发性骨肿瘤。对所有病例进行了骨钙素和碱性磷酸酶的免疫组织化学评估。计算了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和总体准确率。
骨肉瘤患者和其他原发性骨肿瘤患者的平均年龄分别为19.6±13.6岁和40.0±16.3岁。骨钙素在25例骨肉瘤病例中的17例（68%）呈阳性，在25例其他原发性骨肿瘤病例中的16例（64%）呈阳性（P = 0.061）。碱性磷酸酶在25例骨肉瘤病例中的24例（96%）呈阳性，在25例其他原发性骨肿瘤病例中的5例（20%）呈阳性（P < 0.001）。骨钙素在骨肉瘤诊断中的敏感性为68%，特异性、阳性预测值、阴性预测值和总体准确率分别为36%、52%、53%和52%。碱性磷酸酶在骨肉瘤诊断中的敏感性为96%，特异性、阳性预测值、阴性预测值和总体准确率分别为80%、82.7%、95.2%和88%。
碱性磷酸酶免疫组织化学有助于区分骨肉瘤与其他原发性骨肿瘤。在骨肉瘤诊断中，碱性磷酸酶优于骨钙素。骨钙素不能用于区分骨肉瘤和其他原发性骨肿瘤。
