Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK.
Histopathology. 2024 Nov;85(5):820-825. doi: 10.1111/his.15308. Epub 2024 Sep 8.
Recently, SOX17 has emerged as a promising biomarker for non-mucinous Müllerian (ovarian and endometrial) carcinomas, demonstrating increased specificity in comparison to PAX8 while maintaining similar sensitivity. However, expression of SOX17 in mesonephric-like adenocarcinoma (MLA), a carcinoma of the female genital tract with uncertain, but probably Müllerian histogenesis, remains unexplored. This study aims to address this gap.
SOX17 immunohistochemistry was performed on whole tissue sections from 68 MLAs originating from the endometrium or ovary and seven cervical mesonephric carcinomas, as well as six mesonephric remnants/hyperplasias. Using a four-tiered scoring system based on distribution and intensity of staining, 68% of MLA displayed a negative/low (< 10%) SOX17 expression pattern, which contrasts with the high expression observed in most Müllerian carcinomas. However, 22% of MLA demonstrated high SOX17 expression, similar to other endometrial and ovarian carcinomas. Similarly, five of seven (72%) mesonephric carcinomas of the cervix were SOX17-negative, but two cases (28%) were positive. All mesonephric remnants/hyperplasias were SOX17 negative.
The majority of MLA are negative or exhibit low SOX17 expression, in contrast to the diffuse and strong expression commonly seen in other types of Müllerian carcinoma. However, a subset of MLAs demonstrate high SOX17 expression. Therefore, absence of SOX17 staining is supportive for MLA when the differential includes another non-mucinous Müllerian carcinoma. SOX17 may also be useful for differentiating mesonephric remnants/hyperplasias from Müllerian malignancies and benign Müllerian glandular lesions.
最近，SOX17 已成为非黏液性 Müllerian（卵巢和子宫内膜）癌的一种很有前途的生物标志物，与 PAX8 相比，其特异性更高，而敏感性相似。然而，SOX17 在中肾样腺癌（MLA）中的表达情况仍不清楚，MLA 是一种女性生殖道癌，其组织发生不确定，但可能具有 Müllerian 起源。本研究旨在解决这一空白。
对来源于子宫内膜或卵巢的 68 例 MLA 和 7 例宫颈中肾管癌以及 6 例中肾残余/增生的全组织切片进行 SOX17 免疫组织化学染色。使用基于染色分布和强度的四层评分系统，68%的 MLA 显示出阴性/低（<10%）的 SOX17 表达模式，与大多数 Müllerian 癌中观察到的高表达形成对比。然而，22%的 MLA 表现出高 SOX17 表达，与其他子宫内膜和卵巢癌相似。同样，7 例（72%）宫颈中肾管癌中有 5 例 SOX17 阴性，但有 2 例（28%）为阳性。所有中肾残余/增生均为 SOX17 阴性。
大多数 MLA 为阴性或表达低水平的 SOX17，与其他类型的 Müllerian 癌中常见的弥漫性和强表达形成对比。然而，有一部分 MLA 表现出高 SOX17 表达。因此，当鉴别诊断包括另一种非黏液性 Müllerian 癌时，SOX17 染色缺失支持 MLA 的诊断。SOX17 也可用于区分中肾残余/增生与 Müllerian 恶性肿瘤和良性 Müllerian 腺性病变。
