Department of Pathology, Graduate School of Biomedical and Health Science.
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
Am J Surg Pathol. 2020 Sep;44(9):1259-1265. doi: 10.1097/PAS.0000000000001507.
The differential diagnosis of epithelioid mesothelioma from lung adenocarcinoma using immunohistochemistry is improving. However, immunohistochemical markers with high sensitivity and specificity have yet to be identified. In this study, we investigated the utility of sex-determining region Y box 6 (SOX6) as a novel immunohistochemical marker, identified by analyzing previous gene expression data. Immunohistochemically, SOX6 expression was present in 53 of 54 (98%) cases of epithelioid mesothelioma, compared with its expression in only 5 of 69 (7%) cases of lung adenocarcinoma. The sensitivity and specificity of SOX6 expression for differentiating epithelioid mesothelioma and lung adenocarcinoma were 98% and 93%, respectively. SOX6 expression showed similar sensitivity and far better specificity than those of calretinin or podoplanin (D2-40). In addition, SOX6 expression was more sensitive than Wilms' tumor 1 expression. The combination of SOX6 with other markers showed comparable or better sensitivity and specificity relative to other combinations. In particular, the sensitivity of positivity for both SOX6 and calretinin (96%) and the specificity of positivity for both SOX6 and Wilms' tumor 1 (93%) were higher than those of the other combinations. In conclusion, SOX6 is a novel candidate immunohistochemical marker for differentiating epithelioid mesothelioma from lung adenocarcinoma.
使用免疫组织化学对上皮样间皮瘤与肺腺癌进行鉴别诊断的能力正在提高。然而，具有高灵敏度和特异性的免疫组织化学标志物尚未被确定。在这项研究中，我们通过分析先前的基因表达数据，研究了性别决定区 Y 框 6（SOX6）作为一种新的免疫组织化学标志物的效用。免疫组织化学结果显示，54 例上皮样间皮瘤中有 53 例（98%）表达 SOX6，而 69 例肺腺癌中只有 5 例（7%）表达 SOX6。SOX6 表达用于鉴别上皮样间皮瘤和肺腺癌的灵敏度和特异性分别为 98%和 93%。SOX6 表达的灵敏度和特异性均优于钙视网膜蛋白或 podoplanin（D2-40）。此外，SOX6 表达的灵敏度高于 Wilms 瘤 1 表达。SOX6 与其他标志物的组合相对于其他组合具有相当或更好的灵敏度和特异性。特别是，SOX6 与钙视网膜蛋白均阳性的灵敏度（96%）和 SOX6 与 Wilms 瘤 1 均阳性的特异性（93%）均高于其他组合。总之，SOX6 是一种鉴别上皮样间皮瘤与肺腺癌的新型候选免疫组织化学标志物。
