Department of Pathology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, NPL02-950, Dallas, TX, 75390, USA.
Diagn Pathol. 2023 Apr 25;18(1):54. doi: 10.1186/s13000-023-01339-3.
Histomorphological differentiation between pancreatic serous cystadenoma (SCA) and clear cell renal cell carcinoma (RCC) can be challenging. We aimed to study Paired box 8 protein (Pax8) expression profile in cytologic and surgical specimens with pancreatic SCA to assess its utility as a differentiating marker from clear cell RCC.
We characterized Pax8 immunohistochemistry in 33 patients with pancreatic SCA (23 surgical resections and 10 cytology specimens). Nine cytology specimens from metastatic clear cell RCC involving pancreas were used as control tissue. Electronic medical records were reviewed to retrieve clinical information.
All 10 pancreatic SCA cytology specimens, and 16 of 23 pancreatic SCA surgical resections showed absent Pax8 immunostaining, while the remaining 7 surgical resection specimens showed 1%-2% immunoreactivities. Islet and lymphoid cells adjacent to the pancreatic SCA expressed Pax8. In contrast, the proportion of Pax8 immunoreactivity ranged from 50 to 90% (average of 76%) in nine cases of metastatic clear cell RCC involving pancreas. Using a 5% immunoreactivity cutoff, all cases of pancreatic SCA are interpreted as negative for Pax8 immunostains while all cases of metastatic clear cell RCC involving pancreas are interpreted as positive for Pax8 immunostains.
These results suggest that Pax8 immunohistochemistry staining can be a useful adjunct marker to differentiate pancreatic SCA from clear cell RCC in clinical practice. To the best of our knowledge, this is the first large-scale study of Pax8 immunostaining on surgical and cytology specimens with pancreatic SCA.
胰腺浆液性囊腺瘤（SCA）和透明细胞肾细胞癌（RCC）的组织形态学分化具有挑战性。我们旨在研究细胞和手术标本中配对盒 8 蛋白（Pax8）的表达谱，以评估其作为来自透明细胞 RCC 的鉴别标志物的效用。
我们对 33 例胰腺 SCA 患者（23 例手术切除和 10 例细胞学标本）的 Pax8 免疫组化进行了特征描述。9 例胰腺转移透明细胞 RCC 的细胞学标本作为对照组织。回顾电子病历以检索临床信息。
10 例胰腺 SCA 细胞学标本和 23 例胰腺 SCA 手术切除标本中的 16 例均未见 Pax8 免疫染色，而其余 7 例手术切除标本的免疫反应性为 1%-2%。胰岛和淋巴结细胞毗邻胰腺 SCA 表达 Pax8。相比之下，9 例胰腺转移透明细胞 RCC 的 Pax8 免疫反应性比例为 50%至 90%（平均为 76%）。使用 5%的免疫反应性截断值，所有胰腺 SCA 病例的 Pax8 免疫染色均被解释为阴性，而所有胰腺转移透明细胞 RCC 病例的 Pax8 免疫染色均被解释为阳性。
这些结果表明，Pax8 免疫组化染色可作为一种有用的辅助标志物，在临床实践中有助于将胰腺 SCA 与透明细胞 RCC 区分开来。据我们所知，这是首次对胰腺 SCA 的手术和细胞学标本进行 Pax8 免疫染色的大规模研究。
