Department of Pathology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, NO.134 East Street, Gulou District, Fuzhou, Fujian, 350001, P.R. China.
Department of Gastroenterology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, Fujian, P.R. China.
Diagn Pathol. 2024 Oct 29;19(1):144. doi: 10.1186/s13000-024-01568-0.
The traditional diagnostic markers for mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) are synaptophysin (SYP), chromogranin A (CHGA) and CD56. However, there is still a lack of a large series of article focused on the expression of insulinoma-associated protein 1 (INSM1) in gastrointestinal and pancreatic MiNENs. This study compared the expression of INSM1 and traditional neuroendocrine markers in MiNENs. In this study, we collected 46 cases of gastrointestinal and pancreatic MiNENs and performed immunohistochemical staining for INSM1, SYP, CHGA, and CD56. Histologically, the neuroendocrine components of MiNENs were all neuroendocrine carcinomas, with small cell neuroendocrine carcinomas accounting for 15.2% (7/46) and large cell neuroendocrine carcinomas accounting for 84.8% (39/46). With respect to immunohistochemical expression, the overall sensitivity of INSM1 was 80.4% (37/46), which was lower than that of SYP (100%, 46/46), but comparable to that of CHGA (67.4%, 31/46) or CD56 (73.9%, 34/46). The overall specificity of INSM1 was 91.3% (42/46), which was greater than that of SYP (63.0%, 29/46) and CD56 (69.6, 32/46), but was not significantly different from that of CHGA (82.6%, 38/46). The proportion of 3 + staining for SYP (100%, 46/46) was greater than that of INSM1 (71.7, 33/46), while the proportion of 3 + staining for CHGA (10.9, 5/46) or CD56 (21.7, 10/46) was lower than that of INSM1. In conclusion, INSM1 exhibited high sensitivity and specificity in the diagnosis of gastrointestinal and pancreatic MiNENs.
传统的混合神经内分泌-非神经内分泌肿瘤（MiNENs）的诊断标志物是突触素（SYP）、嗜铬粒蛋白 A（CHGA）和 CD56。然而，目前仍然缺乏大量聚焦于胰岛素瘤相关蛋白 1（INSM1）在胃肠道和胰腺 MiNENs 中表达的文章。本研究比较了 INSM1 和传统神经内分泌标志物在 MiNENs 中的表达。在这项研究中，我们收集了 46 例胃肠道和胰腺 MiNENs 病例，并进行了 INSM1、SYP、CHGA 和 CD56 的免疫组织化学染色。组织学上，MiNENs 的神经内分泌成分均为神经内分泌癌，其中小细胞神经内分泌癌占 15.2%（7/46），大细胞神经内分泌癌占 84.8%（39/46）。就免疫组织化学表达而言，INSM1 的总体敏感性为 80.4%（37/46），低于 SYP（100%，46/46），但与 CHGA（67.4%，31/46）或 CD56（73.9%，34/46）相当。INSM1 的总体特异性为 91.3%（42/46），高于 SYP（63.0%，29/46）和 CD56（69.6%，32/46），但与 CHGA（82.6%，38/46）无显著差异。SYP 的 3+染色比例（100%，46/46）大于 INSM1（71.7%，33/46），而 CHGA（10.9%，5/46）或 CD56（21.7%，10/46）的 3+染色比例则低于 INSM1。综上所述，INSM1 在诊断胃肠道和胰腺 MiNENs 中具有较高的敏感性和特异性。
