From the Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Lennartz, Amezada, Höflmayer, Dwertmann Rico, von Bargen, Kind, Reiswich, Viehweger, Lutz, Bertram, Fraune, Gorbokon, Weidemann, Hube-Magg, Menz, Uhlig, Krech, Hinsch, Burandt, Sauter, Simon, Kluth, Lebok, Dum, Minner, Jacobsen, Clauditz, Bernreuther, Steurer).
the Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany (Krech, Lebok).
Arch Pathol Lab Med. 2024 Dec 1;148(12):1327-1336. doi: 10.5858/arpa.2023-0281-OA.
CONTEXT.—: Steroidogenic acute regulatory (StAR) protein is a mitochondrial transport protein with a critical regulatory role for steroid hormone production. The tissue distribution of StAR expression is limited to few human normal tissues.
OBJECTIVE.—: To assess the diagnostic and prognostic value of StAR immunohistochemistry analysis.
DESIGN.—: A tissue microarray containing 19 202 samples from 152 different tumor types and subtypes and 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry.
RESULT.—: StAR immunostaining occurred in 198 (1.2%) of the 17 135 analyzable tumors. StAR expression was observed in 27 of 152 tumor categories, 9 of which included at least 1 strongly positive case. The highest rate of StAR positivity occurred in Leydig cell tumors of the testis and the ovary (100%), steroid cell tumors of the ovary (100%), adrenocortical carcinomas (93%) and adenomas (87%), Sertoli-Leydig cell tumors (67%) and granulosa cell tumors of the ovary (56%), as well as seminomas (7%). Nineteen other tumor entities showed-a usually weak-StAR positivity in less than 6% of cases. A comparison with preexisting Melan-A (a melanocyte antigen) data revealed that StAR was more often positive in adrenocortical neoplasms and in Leydig cell tumors while StAR (but not Melan-A) was negative in Sertoli cell tumors.
CONCLUSIONS.—: Our data provide a comprehensive overview on the patterns of StAR immunostaining in human tumors and suggest a diagnostic utility of StAR immunohistochemistry for supporting a diagnosis of Leydig cell tumors or of normal or neoplastic adrenocortical tissue.
类固醇急性调节蛋白（StAR）是一种线粒体转运蛋白，对类固醇激素的产生具有关键的调节作用。StAR 表达的组织分布仅限于少数人类正常组织。
评估 StAR 免疫组化分析的诊断和预后价值。
通过免疫组化分析了包含 152 种不同肿瘤类型和亚型的 19202 个样本和 608 个 76 种不同正常组织类型的组织微阵列。
在 17135 个可分析肿瘤中的 198 个（1.2%）观察到 StAR 免疫染色。在 27 种肿瘤分类中观察到 StAR 表达，其中 9 种至少包括 1 个强阳性病例。StAR 阳性率最高的是睾丸和卵巢的间质细胞瘤（100%）、卵巢类固醇细胞瘤（100%）、肾上腺皮质癌和腺瘤（93%和 87%）、Sertoli-Leydig 细胞瘤（67%）和卵巢颗粒细胞瘤（56%），以及精原细胞瘤（7%）。其他 19 种肿瘤实体通常在不到 6%的病例中表现出较弱的 StAR 阳性。与现有的 Melan-A（一种黑素细胞抗原）数据进行比较表明，StAR 在肾上腺皮质肿瘤和间质细胞瘤中更常呈阳性，而在 Sertoli 细胞瘤中 StAR（但不是 Melan-A）呈阴性。
我们的数据提供了人类肿瘤中 StAR 免疫组化染色模式的全面概述，并表明 StAR 免疫组化在支持间质细胞瘤或正常或肿瘤性肾上腺皮质组织的诊断方面具有诊断效用。
