STK11 (LKB1) immunohistochemistry is a sensitive and specific marker for STK11 adnexal tumours

IF 3.9 2区医学 Q2 CELL BIOLOGY Histopathology Pub Date : 2024-08-21 DOI:10.1111/his.15303

Amir Dehghani, Aarti E Sharma, Stephanie E Siegmund, Chrystalle K Carreon, Colin J R Stewart, Fabiola Medeiros, Jelena Mirkovic, Marisa R Nucci, Christopher P Crum, Jason L Hornick, Brooke E Howitt, W Glenn McCluggage, David L Kolin

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Abstract

Aims

STK11 adnexal tumour is a rare, recently described malignant neoplasm that is associated with Peutz–Jeghers syndrome. [Correction added on 3 October 2024, after first online publication: ‘ST11’ in preceding sentence has been corrected to ‘STK11’ in this version.] It predominantly originates from the para-adnexal soft tissues and often shows secondary involvement of the fallopian tube and ovary. STK11 adnexal tumours have a broad differential diagnosis due to their variable morphology and non-specific immunoprofile, and diagnostic confirmation currently requires sequencing to identify an STK11 mutation. We investigate the diagnostic utility of STK11 (LKB1) immunohistochemistry (IHC) in a cohort of STK11 adnexal tumours and morphological mimics.

Methods and results

IHC for STK11 was performed on 122 tumours, including 17 STK11 adnexal tumours and 105 morphological mimics (10 female adnexal tumours of Wolffian origin, 22 adult granulosa cell tumours, 10 juvenile granulosa cell tumours, four Sertoli–Leydig cell tumours, two Leydig cell tumours, one Sertoli cell tumour, one steroid cell tumour, four extra-ovarian sex cord-stromal tumours, 16 ovarian endometrioid carcinomas, eight tubo-ovarian high-grade serous carcinomas, five ovarian mesonephric-like adenocarcinomas, 14 ovarian carcinosarcomas, five peritoneal malignant mesotheliomas, two pelvic plexiform leiomyomata and one ovarian solid pseudopapillary tumour). All STK11 adnexal tumours showed complete loss of cytoplasmic staining for STK11. All other tumour types showed retained cytoplasmic staining, except for one endometrioid carcinoma with mucinous differentiation which showed complete loss of STK11 expression and a high-grade serous carcinoma with subclonal loss.

Conclusions

STK11 is a highly sensitive and specific immunohistochemical marker for distinguishing STK11 adnexal tumour from its histological mimics, and can obviate the need for confirmatory molecular studies in the appropriate morphological context.

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STK11 (LKB1) 免疫组化是 STK11 附件肿瘤敏感而特异的标记物。

目的：ST11 附件肿瘤是最近描述的一种罕见恶性肿瘤，与 Peutz-Jeghers 综合征有关。它主要起源于附件旁软组织，通常继发于输卵管和卵巢。STK11 附件肿瘤由于其形态多变和非特异性免疫特征而具有广泛的鉴别诊断，目前确诊需要通过测序来确定 STK11 基因突变。我们研究了STK11（LKB1）免疫组化（IHC）在一组STK11附件肿瘤和形态学模拟物中的诊断效用：对122例肿瘤进行了STK11免疫组化，其中包括17例STK11附件肿瘤和105例形态学拟态肿瘤（10例沃尔夫源性女性附件肿瘤、22例成人颗粒细胞瘤、10例幼年颗粒细胞瘤、4例Sertoli-Leydig细胞瘤、2例Leydig细胞瘤、1例Sertoli细胞瘤、1例类固醇细胞瘤、4例卵巢外性索状细胞瘤）、4例卵巢外性索间质瘤、16例卵巢子宫内膜样癌、8例输卵管卵巢高级别浆液性癌、5例卵巢间质样腺癌、14例卵巢癌肉瘤、5例腹膜恶性间皮瘤、2例盆腔丛状子宫肌瘤和1例卵巢实性假乳头状瘤）。所有 STK11 附件肿瘤的 STK11 细胞质染色均完全消失。所有其他类型的肿瘤都显示保留了细胞质染色，只有一种粘液分化的子宫内膜样癌显示 STK11 表达完全丧失，一种高级别浆液性癌显示亚克隆丧失：STK11是一种高度敏感且特异的免疫组化标记物，可用于区分STK11附件肿瘤及其组织学模拟物，并可避免在适当的形态学背景下进行确证性分子研究。

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来源期刊

Histopathology 医学-病理学

CiteScore

10.20

自引率

4.70%

发文量

239

审稿时长

1 months

期刊介绍： Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.