SATB2 和 MOC-31 免疫标记在区分分化较差的直肠腺癌和肛门鳞状细胞癌方面的实用性

IF 1.3 4区 医学 Q3 ANATOMY & MORPHOLOGY Applied Immunohistochemistry & Molecular Morphology Pub Date : 2024-09-01 Epub Date: 2024-08-15 DOI:10.1097/PAI.0000000000001218
Jiayun M Fang, Naziheh Assarzadegan, Jerome Cheng, Laura Lamps
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引用次数: 0

摘要

目的:结肠直肠腺癌和鳞状细胞癌(SCC)可发生于肛门直肠,如果分化不佳,会给诊断带来很大的挑战。准确的诊断会对治疗产生重大影响,因为这些疾病的治疗涉及不同的新辅助化放疗方案。MOC-31 和 SATB2 分别被用作腺体分化和结肠直肠起源的特异性标志物,但研究表明,它们在其他部位的鳞状细胞癌中也可能呈阳性。这让人担心 MOC-31 和 SATB2 可能会在肛门直肠鳞状细胞癌中呈阳性,而过度依赖这些染色可能会成为区分直肠分化不良腺癌 (PDA) 和肛门非角化性 SCC 的潜在诊断陷阱:我们确定了 10 例直肠 PDA 和 17 例肛门直肠非角化性 SCC 的活组织样本,并对其进行了 MOC-31 和 SATB2 染色:结果:我们发现 MOC-31 具有高度敏感性,在 10/10 例直肠 PDA 中呈阳性,但不具有特异性,因为在 11/17 例 SCC 中也呈阳性。相比之下,SATB2 既有敏感性,在 10/10 例直肠 PDA 中呈阳性染色,又有特异性,在 17/17 例 SCC 中呈阴性染色。其中包括 4 例染色阴性的 SCC 病例。MOC-31 的敏感性为 100%,特异性为 35.3%,而 SATB2 的敏感性为 100%,特异性为 100%:结论:与头颈部和食道的鳞状粘膜不同,肛门的 SCC 并不经常对 SATB2 呈阳性染色。这些数据表明,SATB2 是区分直肠 PDA 和肛门直肠非角化性 SCC 的可靠标志物,而 MOC-31 在肛门 SCC 中通常呈阳性。还需要注意的是,SCC 中也可能出现 SATB2 染色不明确的情况。
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Utility of SATB2 and MOC-31 Immunostains to Distinguish Between Poorly Differentiated Rectal Adenocarcinoma and Anal Squamous Cell Carcinoma.

Objectives: Colorectal adenocarcinoma and squamous cell carcinoma (SCC) can arise in the anorectum and present a significant diagnostic challenge when poorly differentiated. Accurate diagnosis can significantly influence management, as the treatments for these conditions involve distinct neoadjuvant chemoradiotherapy regimens. MOC-31 and SATB2 have been utilized as specific markers of glandular differentiation and colorectal origin, respectively, but studies have shown that they may be positive in squamous cell carcinoma of other sites. This raises the concern that MOC-31 and SATB2 may be positive in squamous cell carcinoma of the anorectum, and overreliance on these stains may be a potential diagnostic pitfall in differentiating rectal poorly differentiated adenocarcinoma (PDA) from anal nonkeratinizing SCC.

Methods: We identified biopsies from 10 rectal PDA and 17 anorectal nonkeratinizing SCC cases and stained them for MOC-31 and SATB2.

Results: We found that MOC-31 was highly sensitive, being positive in 10/10 cases of rectal PDA, but not specific, as it was also positive in 11/17 SCC cases. In contrast, SATB2 was both sensitive, with positive staining in 10/10 rectal PDA cases, and specific, with negative staining in 17/17 SCC cases. This includes equivocal staining in 4 of these negative SCC cases. MOC-31 had a sensitivity of 100% and specificity of 35.3%, while SATB2 had a sensitivity of 100% and specificity of 100%.

Conclusions: Unlike squamous mucosa of the head and neck, and esophagus, SCC of the anus does not frequently stain positively for SATB2. These data suggest that SATB2 is a reliable marker in distinguishing rectal PDA from anorectal nonkeratinizing SCC, whereas MOC-31 is commonly positive in SCC of the anus. It is also important to note that equivocal SATB2 staining may be seen in SCC.

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来源期刊
Applied Immunohistochemistry & Molecular Morphology
Applied Immunohistochemistry & Molecular Morphology ANATOMY & MORPHOLOGY-MEDICAL LABORATORY TECHNOLOGY
CiteScore
3.20
自引率
0.00%
发文量
153
期刊介绍: ​Applied Immunohistochemistry & Molecular Morphology covers newly developed identification and detection technologies, and their applications in research and diagnosis for the applied immunohistochemist & molecular Morphologist. Official Journal of the International Society for Immunohistochemisty and Molecular Morphology​.
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