Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Urology, The Cancer Center of Sun Yat-sen University, Guangzhou, China.
Cancer Med. 2024 Mar;13(5):e6813. doi: 10.1002/cam4.6813.
TFE3 immunohistochemistry (TFE3-IHC) is controversial in the diagnosis of TFE3-rearranged renal cell carcinoma (TFE3-rearranged RCC). This study is to investigate the accuracy and sensitivity of IHC and establish a predictive model to diagnose TFE3-rearranged RCC.
Retrospective analysis was performed by collecting IHC and fluorescence in situ hybridization (FISH) results from 228 patients. IHC results were evaluated using three scoring systems. Scoring system 1 is graded based on nuclear staining intensity, scoring system 2 is graded based on the percentage of stained tumor cell nuclei, and scoring system 3 is graded based on both the nuclear staining intensity and the percentage. We collected patients' IHC results and clinical information. Important variables were screened based on univariate logistic regression analysis. Then, independent risk factors were established through multivariate logistic regression, and a nomogram model was constructed. The model was validated in internal test set and external validation set. The receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis (DCA) were generated to assess discriminative ability of the model.
The accuracy of IHC based on three scoring systems were 0.829, 0.772, and 0.807, respectively. The model included four factors including age, gender, lymph node metastasis and IHC results. Area under the curve (AUC) values were 0.935 for the training set, 0.934 for the internal test set, 0.933 for all 228 patients, and 0.916 for the external validation set.
TFE3 IHC has high accuracy in the diagnosis of TFE3-rearranged RCC. Clinical information such as age and lymph node metastasis are independent risk factors, which can be used as a supplement to the results of TFE3 IHC. This study confirms the value of IHC in the diagnosis of TFE3-rearranged RCC. The accuracy of the diagnosis can be improved by incorporating IHC with other clinical risk factors.
TFE3 免疫组化（TFE3-IHC）在 TFE3 重排型肾细胞癌（TFE3-rearranged RCC）的诊断中存在争议。本研究旨在探讨 IHC 的准确性和敏感性，并建立预测模型以诊断 TFE3 重排型 RCC。
通过收集 228 例患者的 IHC 和荧光原位杂交（FISH）结果进行回顾性分析。使用三种评分系统评估 IHC 结果。评分系统 1 根据核染色强度分级，评分系统 2 根据染色肿瘤细胞核的百分比分级，评分系统 3 根据核染色强度和百分比分级。我们收集了患者的 IHC 结果和临床信息。基于单因素逻辑回归分析筛选重要变量。然后，通过多因素逻辑回归建立独立风险因素，并构建列线图模型。该模型在内部测试集和外部验证集中进行验证。通过生成受试者工作特征曲线（ROC 曲线）、校准曲线和决策曲线分析（DCA）来评估模型的判别能力。
基于三种评分系统的 IHC 准确性分别为 0.829、0.772 和 0.807。模型包括年龄、性别、淋巴结转移和 IHC 结果四个因素。训练集的曲线下面积（AUC）值为 0.935，内部测试集为 0.934，所有 228 例患者为 0.933，外部验证集为 0.916。
TFE3 IHC 对 TFE3 重排型 RCC 的诊断具有较高的准确性。年龄和淋巴结转移等临床信息是独立的危险因素，可以作为 TFE3 IHC 结果的补充。本研究证实了 IHC 在诊断 TFE3 重排型 RCC 中的价值。通过将 IHC 与其他临床危险因素相结合，可以提高诊断的准确性。
