ODF1在肾上腺嗜铬细胞瘤/副神经节瘤和皮质腺瘤鉴别诊断中的应用价值

Application of immunohistochemical staining of ODF1 in differential diagnosis between pheochromocytoma/paraganglioma and adrenocortical adenoma

目的研究ODF1在肾上腺嗜铬细胞瘤/副神经节瘤和皮质腺瘤鉴别诊断中的应用价值。方法收集2017-01—2020-07确诊的10例嗜铬细胞瘤、5例副神经节瘤、15例肾上腺皮质腺瘤和10例正常肾上腺组织,进行ODF1、嗜铬素A(CgA)和类固醇生成因子-1(SF-1)免疫组织化学染色,观察它们的表达。结果所有嗜铬细胞瘤(10/10)、5/5例副神经节瘤及肿瘤周围正常髓质(10/10)均呈ODF1和CgA弥漫阳性表达,SF-1阴性表达。所有肾上腺皮质腺瘤(15/15)及肿瘤周围正常皮质(15/15)均呈SF-1阳性表达,ODF1阴性表达。CgA在肾上腺皮质腺瘤的阳性表达率为6.7%(1/15)。ODF1和SF-1表达组合对于诊断肾上腺嗜铬细胞瘤/副神经节瘤和皮质腺瘤的敏感性和特异性均为100%。10例嗜铬细胞瘤、5例副神经节瘤和15例肾上腺皮质腺瘤周围的肾上腺组织以及10例正常肾上腺组织中皮质均表达SF-1(100%),髓质均表达ODF1和CgA。结论ODF1可作为诊断嗜铬细胞瘤/副神经节瘤的新型免疫组织化学标记物,与SF-1联合可经济、有效地鉴别肾上腺嗜铬细胞瘤/副神经节瘤和皮质腺瘤。

Objective To study the application of immunohistochemical staining of ODF1 in differential diagnosis between pheochromocytoma/paraganglioma and adrenocortical adenoma.Methods Ten cases of pheochromocytoma,5 cases of paraganglioma,15 cases of adrenocortical adenoma and 10 cases of normal adrenal gland tissue were collected from January 2017 to July 2020 and analyzed by immunohistochemistry for ODF1,chromogranin A(CgA)and steroid-producing factor-1(SF-1).Results ODF1 and CgA were diffuse positive in all pheochromocytomas,paraganglioma and normal medulla around the pheochromocytomas,while SF-1 was negative.SF-1 was positive in all adrenocortical adenomas and normal cortex around the adrenocortical adenomas,while ODF1 was negative.CgA expression was presented in 1 case of adrenocortical adenoma.The sensitivity and specificity of the panel including ODF1 and SF-1 for the diagnosis of pheochromocytoma/paraganglioma and adrenocortical adenoma were all 100%.SF-1 was expressed in the cortex of 10 normal adrenal gland and the adrenal gland around pheochromocytomas,5 cases of paraganglioma,and 15 adrenocortical adenomas,while ODF1 and CgA were expressed in medulla.Conclusion ODF1 may be a novel immunohistochemical marker for the diagnosis of pheochromocytoma/paraganglioma.The panel of ODF1 and SF-1 can help differentiate pheochromocytoma/paraganglioma from adrenocortical adenoma economically and effectively.