PAX8在恶性腹膜间皮瘤和良性间皮瘤的表达及其在与腹膜转移性卵巢浆液性癌鉴别诊断中的意义

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  恶性腹膜间皮瘤(malignant peritoneal mesothelioma, MPM)与累及腹膜浆液性癌的鉴别仍然是诊断中的一个挑战,特别是对于小活检标本和细胞学标本。在两者鉴别中,PAX8表达被认为是浆液性癌的特异性标志物。此外,有文献报道,区别于良性间皮病变和卵巢浆液性肿瘤(ovarian serous tumors, OST),恶性腹膜间皮瘤具有特异的BAP1表达缺失。我们通过免疫组织化学方法检测了27例恶性腹膜间皮瘤、25例良性间皮细胞病变和45例OST中PAX8和BAP1表达。5例MPM表达PAX8+(5/27,18%),8例良性间皮细胞病变表达PAX8 (8/25, 32%)。女性患者中间皮表达PAX8较男性患者更为常见(P=0.01)。16例MPM的BAP1表达缺失(16/25,64%),而在所有良性间皮细胞及所有OST中BAP1表达无缺失。所有PAX8+病例中,间皮细胞雌激素受体均为阴性。这些数据表明,PAX8在良性和恶性间皮细胞中均可表达,相较于良性间皮细胞病变和OST,BAP1表达缺失对于MPM高度特异。这些结果对于OST的初步诊断及病理分期也具有重要意义。通过检测PAX8表达来鉴别间皮源性与浆液性病变时一定要慎重,对于倾向间皮瘤的病例可通过检测BAP1表达缺失来证实。
Am.J Surg Pathol 2017;41:1675-1682
美国外科病理学杂志中文版2018年第二期摘要No.7
李杜鹃 翻译 邱雪杉 审校
  The American Journal of Surgical Pathology中文版声明:
  ©2018 Wolters Kluwer Health
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