Department of Laboratory Medicine and Molecular Diagnostics, Division of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Department of Laboratory Medicine and Pathobiology, 1 King's College, University of Toronto, Toronto, Ontario, Canada.
Histopathology. 2019 Oct;75(4):552-558. doi: 10.1111/his.13887. Epub 2019 Aug 8.
Gastric-type endocervical adenocarcinoma (EA) is characterised by aggressive behaviour and pathogenesis independent of human papillomavirus infection. Because of its morphology and frequent mutation-pattern expression of p53, gastric-type EA may be confused with several types of endometrial carcinoma, particularly in biopsy and curettage specimens. HIK1083 and MUC6 are immunohistochemical markers used to support a diagnosis of gastric-type EA; however, the rates of expression of these markers in endometrial tumours are largely unknown. We therefore aimed to assess the expression of HIK1083 and MUC6 in a cohort of different types of endometrial carcinoma.
Ninety-one endometrial carcinomas (56 endometrioid, 16 clear cell, and 19 serous) from 91 patients treated with hysterectomy were included. A representative tumour block from each case was used for immunohistochemical staining with HIK1083 and MUC6. The percentage of stained cells (0-100%) and average staining intensity (weak, moderate, and strong) were recorded for both markers. None of 91 cases expressed HIK1083. In contrast, 66% (60/91) of cases showed at least focal expression of MUC6; importantly, 54 of 60 (90%) positive cases showed moderate or strong staining. Five of 60 (8%) cases showed MUC6 staining in ≥50% of tumour cells. Endometrioid tumours (49/56, 88%) were more likely to express MUC6 than cases of clear cell (1/16, 6%) or serous (10/19, 53%) carcinoma.
Endometrial carcinoma often expresses MUC6. In contrast, HIK1083 is consistently negative, and thus, when positive, is a more reliable marker for distinguishing gastric-type EA from some of its endometrial mimics.
胃型宫颈内膜腺癌(EA)以侵袭性行为和发病机制为特征,与人类乳头瘤病毒感染无关。由于其形态学和 p53 的频繁突变模式表达,胃型 EA 可能与几种子宫内膜癌混淆,特别是在活检和刮宫标本中。HIK1083 和 MUC6 是用于支持胃型 EA 诊断的免疫组织化学标志物;然而,这些标志物在子宫内膜肿瘤中的表达率在很大程度上尚不清楚。因此,我们旨在评估 HIK1083 和 MUC6 在不同类型子宫内膜癌中的表达。
纳入 91 例因子宫切除术治疗的子宫内膜癌患者(56 例子宫内膜样癌、16 例透明细胞癌和 19 例浆液性癌)。每个病例的代表性肿瘤块均用于 HIK1083 和 MUC6 的免疫组织化学染色。记录两种标志物的染色细胞百分比(0-100%)和平均染色强度(弱、中、强)。91 例均无 HIK1083 表达。相比之下,66%(60/91)的病例至少有局灶性 MUC6 表达;重要的是,54 例(90%)阳性病例显示中或强染色。5 例(8%)病例有≥50%的肿瘤细胞 MUC6 染色。子宫内膜样癌(49/56,88%)比透明细胞癌(1/16,6%)或浆液性癌(10/19,53%)更可能表达 MUC6。
子宫内膜癌常表达 MUC6。相比之下,HIK1083 始终为阴性,因此阳性时,是区分胃型 EA 与一些子宫内膜类似物的更可靠标志物。