Sugawara Emiko, Shigematsu Yasuyuki, Amori Gulanbar, Sugita Keisuke, Yonese Junji, Takeuchi Kengo, Inamura Kentaro
Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Diagnostics (Basel). 2023 Jul 19;13(14):2408. doi: 10.3390/diagnostics13142408.
Female urethral adenocarcinoma has attracted attention as a rare tumor type based on its differential pathogenesis from its male counterpart. However, to date, our knowledge concerning its immunohistochemical and morphological characteristics remains limited due to the small number of cases studied. In this study, nine consecutive cases of female urethral adenocarcinoma were used for immunohistochemical and morphological characterization of the tumor based on semi-comprehensive immunohistochemical analysis and detailed morphological evaluations. Our immunohistochemical assay revealed two subtypes of female urethral adenocarcinoma with distinctive staining patterns: the CDX2- and PAX8-expressing subtypes. The former stained positive for other intestinal markers (e.g., HNF4α and TFF1) as well (7 of 7 cases); the latter stained negative for these intestinal markers (0 of 2 cases) but stained positive for clear cell carcinoma markers (e.g., Napsin A and HNF1β) (2 of 2 cases). Regarding cytokeratins, the former displayed a CK7- and CK20-positive immunoprofile (7 of 7 cases); the latter exhibited a CK7-positive and CK20-negative immunoprofile (2 of 2 cases). Morphologically, CDX2- and PAX8-expressing subtypes resembled intestinal-type adenocarcinoma and clear cell carcinoma (occurring in gynecological organs), respectively. The semi-comprehensive immunoprofiling data presented in this study can potentially contribute to the correct diagnosis of this rare tumor type. Finally, our study represents an important basis for future investigations aiming to further elucidate the details and origin of female urethral adenocarcinoma, and it can potentially contribute to developing diagnostic and therapeutic strategies for treating this malignancy.
女性尿道腺癌作为一种罕见的肿瘤类型，因其与男性尿道腺癌在发病机制上的差异而受到关注。然而，迄今为止，由于研究的病例数量较少，我们对其免疫组化和形态学特征的了解仍然有限。在本研究中，基于半综合免疫组化分析和详细的形态学评估，连续选取9例女性尿道腺癌病例，对肿瘤进行免疫组化和形态学特征分析。我们的免疫组化检测揭示了女性尿道腺癌的两种亚型，具有独特的染色模式：表达CDX2和PAX8的亚型。前者对其他肠道标志物（如HNF4α和TFF1）也呈阳性染色（7例中的7例）；后者对这些肠道标志物呈阴性染色（2例中的0例），但对透明细胞癌标志物（如Napsin A和HNF1β）呈阳性染色（2例中的2例）。关于细胞角蛋白，前者表现为CK7和CK20阳性免疫表型（7例中的7例）；后者表现为CK7阳性和CK20阴性免疫表型（2例中的2例）。形态学上，表达CDX2和PAX8的亚型分别类似于肠型腺癌和透明细胞癌（发生于妇科器官）。本研究中呈现的半综合免疫谱数据可能有助于对这种罕见肿瘤类型进行正确诊断。最后，我们的研究为未来旨在进一步阐明女性尿道腺癌细节和起源的研究奠定了重要基础，并且可能有助于制定针对这种恶性肿瘤的诊断和治疗策略。
