Wang Minhua, Abi-Raad Rita, Adeniran Adebowale J, Cai Guoping
Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA.
J Clin Transl Pathol. 2021 Dec;1(1):16-20. Epub 2021 Dec 15.
NKX3.1 is an emerging marker for tumors of prostatic origin; however, the utility and diagnostic values of NKX3.1 have not been broadly studied in cytology specimens. The purpose of this study is to determine the performance of NKX3.1, compared to prostatic specific antigen (PSA) and prostatic specific alkaline phosphatase (PSAP), as an organ-specific marker of metastatic prostatic adenocarcinoma (MPAC) in cytology specimens.
The cytology specimens, which had been evaluated to include or exclude MPAC, were collected from our pathology database. Immunostains for PSA, PSAP, and NKX3.1 were performed on cell block sections.
A total of 118 cases were collected. In 37 MPACs, NKX3.1 was diffusely positive in 34 cases (92%) and focally positive in 3 cases (8%). PSA indicated diffuse positivity in 16 cases (43%), focal positivity in 13 (35%) cases, and was negative in 8 (22%) cases. PSAP immunostain was performed in only 12 MPACs, showing diffuse positivity in 5 (42%), focal positivity in 3 (25%), and negativity in 4 (33%) cases. Among the 81 non-metastatic prostatic adenocarcinoma cases, NKX3.1 was negative in 80 (99%) cases and focally positive in only 1 (1%) case; all cases with available PSA and PSAP staining were negative. The calculated sensitivities for NKX3.1, PSA, and PSAP were 100%, 78%, and 67%, respectively, while the specificities were 99%, 100%, and 100%, respectively.
Compared to PSA and PSAP, NKX3.1 is more reliable as an individual marker for MPAC in cytology specimens. Combining NKX3.1 and PSA can be useful in some cases to enhance diagnostic utility.
NKX3.1是一种新兴的前列腺源性肿瘤标志物；然而，NKX3.1在细胞学标本中的应用及诊断价值尚未得到广泛研究。本研究的目的是确定与前列腺特异性抗原（PSA）和前列腺特异性碱性磷酸酶（PSAP）相比，NKX3.1作为转移性前列腺腺癌（MPAC）细胞学标本中器官特异性标志物的性能。
从我们的病理数据库中收集已评估以纳入或排除MPAC的细胞学标本。对细胞块切片进行PSA、PSAP和NKX3.1的免疫染色。
共收集118例病例。在37例MPAC中，NKX3.1弥漫性阳性34例（92%），局灶性阳性3例（8%）。PSA显示弥漫性阳性16例（43%），局灶性阳性13例（35%），阴性8例（22%）。仅对12例MPAC进行了PSAP免疫染色，显示弥漫性阳性5例（42%），局灶性阳性3例（25%），阴性4例（33%）。在81例非转移性前列腺腺癌病例中，NKX3.1阴性80例（99%），仅局灶性阳性1例（1%）；所有有PSA和PSAP染色结果的病例均为阴性。计算得出NKX3.1、PSA和PSAP的敏感性分别为100%、78%和67%，特异性分别为99%、100%和100%。
与PSA和PSAP相比，NKX3.1作为MPAC细胞学标本的单独标志物更可靠。在某些情况下，联合使用NKX3.1和PSA有助于提高诊断效用。
