INSM1 是胃肠道、阑尾和胰腺原发性肿瘤神经内分泌分化的高度特异性标志物。
INSM1 Is a Highly Specific Marker of Neuroendocrine Differentiation in Primary Neoplasms of the Gastrointestinal Tract, Appendix, and Pancreas.
机构信息
Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH.
出版信息
Am J Clin Pathol. 2020 May 5;153(6):811-820. doi: 10.1093/ajcp/aqaa014.
OBJECTIVES
INSM1 has been described as a sensitive and specific neuroendocrine marker. This study aims to compare INSM1 with traditional neuroendocrine markers in gastrointestinal neuroendocrine neoplasms.
METHODS
Retrospective review (2008-2018) was used to retrieve paraffin-embedded tissue from 110 gastrointestinal neuroendocrine neoplasms and controls that was subsequently stained with INSM1, synaptophysin, chromogranin, CD56, and Ki-67.
RESULTS
INSM1 was positive in 16 of 17 (94.1%) gastric, 17 of 18 (94.4%) pancreatic, 13 of 18 (72.2%) small bowel, 17 of 21 (81.0%) colonic, and 26 of 36 (72.2%) appendiceal tumors. INSM1 was positive in 58 of 70 (82.9%) well-differentiated neuroendocrine tumors, 17 of 20 (85.0%) poorly differentiated neuroendocrine carcinomas, 8 of 11 (72.7%) low-grade goblet cell adenocarcinomas (grade 1), and 6 of 9 (66.7%) high-grade goblet cell adenocarcinomas (grade 2/3). INSM1 sensitivity for neuroendocrine neoplasms (80.9%) was less than that of synaptophysin (99.1%), chromogranin (88%), and CD56 (95.3%); specificity was higher (95.7% vs 86.0%, 87.3%, and 86.0%, respectively).
CONCLUSIONS
INSM1 is a useful marker of neuroendocrine differentiation in gastrointestinal neuroendocrine and mixed neuroendocrine neoplasms. Compared with traditional neuroendocrine markers, INSM1 is less sensitive but more specific.
目的
INSM1 已被描述为一种敏感且特异的神经内分泌标志物。本研究旨在比较 INSM1 与胃肠道神经内分泌肿瘤中的传统神经内分泌标志物。
方法
采用回顾性研究（2008-2018 年），检索了 110 例胃肠道神经内分泌肿瘤和对照的石蜡包埋组织，随后用 INSM1、突触素、嗜铬粒蛋白、CD56 和 Ki-67 进行染色。
结果
INSM1 在 17 例胃神经内分泌肿瘤中阳性 16 例（94.1%），在 18 例胰腺神经内分泌肿瘤中阳性 17 例（94.4%），在 18 例小肠神经内分泌肿瘤中阳性 13 例（72.2%），在 21 例结肠神经内分泌肿瘤中阳性 17 例（81.0%），在 36 例阑尾神经内分泌肿瘤中阳性 26 例（72.2%）。INSM1 在 70 例分化良好的神经内分泌肿瘤中阳性 58 例（82.9%），在 20 例分化差的神经内分泌癌中阳性 17 例（85.0%），在 11 例低级别杯状细胞腺癌（1 级）中阳性 8 例（72.7%），在 9 例高级别杯状细胞腺癌（2/3 级）中阳性 6 例（66.7%）。神经内分泌肿瘤中 INSM1 的敏感性（80.9%）低于突触素（99.1%）、嗜铬粒蛋白（88%）和 CD56（95.3%）；特异性更高（95.7%比 86.0%、87.3%和 86.0%）。
结论
INSM1 是胃肠道神经内分泌和混合神经内分泌肿瘤中神经内分泌分化的有用标志物。与传统神经内分泌标志物相比，INSM1 的敏感性较低，但特异性较高。
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