免疫组化 β-连环蛋白核表达可作为子宫内膜癌 CTNNB1 外显子 3 突变的替代标志物。
Immunohistochemical Nuclear Expression of β-Catenin as a Surrogate of CTNNB1 Exon 3 Mutation in Endometrial Cancer.
机构信息
Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine.
Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine.
出版信息
Am J Clin Pathol. 2019 Apr 2;151(5):529-538. doi: 10.1093/ajcp/aqy178.
OBJECTIVES
CTNNB1 exon 3 mutations have shown independent prognostic value in endometrial cancer. We aimed to assess whether nuclear β-catenin expression is an accurate surrogate, as immunohistochemistry is cheaper, faster, and more widely applicable than sequencing.
METHODS
A systematic review was performed by searching electronic databases for all studies assessing the association between β-catenin immunohistochemical expression and CTNNB1 mutations. Meta-analysis of diagnostic accuracy was performed by calculating sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratio (DOR), and area under the curve (AUC) on summary receiver operating characteristic curves.
RESULTS
Fifteen observational studies with 1,158 endometrial carcinomas were included. Pooled estimates showed sensitivity = 0.88, specificity = 0.85, LR+ = 4.57, LR- = 0.20, DOR = 27.16, and high diagnostic accuracy (AUC = 0.91).
CONCLUSIONS
Nuclear expression of β-catenin is an accurate immunohistochemical surrogate of CTNNB1 exon 3 mutations and thus might be considered in the risk stratification of endometrial cancer.
目的
CTNNB1 外显子 3 突变在子宫内膜癌中具有独立的预后价值。我们旨在评估核 β-连环蛋白表达是否是一种准确的替代物，因为免疫组织化学比测序更便宜、更快且更广泛适用。
方法
通过搜索电子数据库，对所有评估β-连环蛋白免疫组织化学表达与 CTNNB1 突变之间关联的研究进行了系统评价。通过计算敏感性、特异性、阳性和阴性似然比（LR+和 LR-）、诊断优势比（DOR）和汇总受试者工作特征曲线下的面积（AUC），对诊断准确性进行了荟萃分析。
结果
共纳入了 15 项观察性研究，包含 1158 例子宫内膜癌。汇总估计显示敏感性=0.88，特异性=0.85，LR+=4.57，LR-=0.20，DOR=27.16，具有较高的诊断准确性（AUC=0.91）。
结论
核 β-连环蛋白的表达是 CTNNB1 外显子 3 突变的一种准确免疫组化替代物，因此可能被考虑用于子宫内膜癌的风险分层。
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