SOX-10及GATA-3在涎腺恶性上皮性肿瘤中的表达及意义

Diagnostic value of combined detection of SOX-10 and GATA-3 in the diagnosis of malignant epithelial tumors of the salivary gland

目的目前对可用于涎腺恶性上皮性肿瘤鉴别诊断的抗体的研究较少.文中旨在比较SOX-10和GATA结合蛋白3(GATA-binding protein 3,GATA-3)在涎腺恶性上皮性肿瘤中的表达,探讨SOX-10和GATA-3在涎腺恶性上皮性肿瘤的诊断价值。方法收集南京军区南京总医院病理科2008年1月至2016年6月行手术治疗的涎腺恶性上皮性肿瘤患者72例,其中包括16例腺泡细胞癌、12例腺样囊性癌、12例涎腺导管癌、10例黏液表皮样癌、10例肌上皮癌、6例类乳腺分泌癌、4例基底细胞腺癌、1例癌在多形性腺瘤中和1例上皮-肌上皮癌。应用免疫组化En Vision法检测肿瘤标本中SOX-10和GATA-3的表达,比较SOX-10和GATA-3在肿瘤中的阳性表达率,分析SOX-10和GATA-3单独或联合使用对涎腺恶性肿瘤诊断的价值。结果 16例腺泡细胞癌、6例类乳腺分泌癌及1例上皮-肌上皮癌,SOX-10均呈明确的弥漫强阳性表达(3+),阳性率均为100%;12例腺样囊性癌中,11例SOX-10中等(2+)到强阳性(3+)表达,阳性率为91.7%;10例肌上皮癌中,9例SOX-10中等(2+)到强阳性(3+)表达,阳性率为90%。1例癌在多形性腺瘤中GATA-3弥漫强阳性(3+)表达,阳性率为100%。CD117阳性表达于所有的腺样囊性癌和基底细胞腺瘤,其中在腺样囊性癌中为弥漫性中等(2+)至强阳性(3+)表达。在类乳腺分泌癌中,S-100呈弥漫强阳性表达(3+)。结论 SOX-10和GATA-3在涎腺恶性上皮性肿瘤的鉴别诊断中具有一定的价值,可与其他常用于涎腺的免疫标记联合使用,作为辅助诊断的手段。

Objective At present, there are few studies about the antibodies for differential diagnosis of malignant epithelial tumors of the salivary gland. Our aim is to compare the expression of SOX-10 and GATA-binding protein（ GATA-3） , and to study the diagnostic value of SOX-10 and GATA-3 in malignant epithelial tumors of the salivary gland. Methods We collected 72 cases were treated surgically from January 2008 to June 2016 in the Department of Pathology, Nanjing General Hospital of Nanjing Military Com-mand, which included 16 cases of acinic cell carcinoma （ AciCC） , 12 cases of adenoid cystic carcinoma （ AdCC） , 12 cases of salivary duct carcinoma, 10 cases of mucoepidermoid carcinoma （ MEC） , 10 cases of myoepithelial carcinoma, 6 cases of mammary analogue secretory carcinoma （ MASC） , 4 cases of basal cell adenocarcinoma （ BCAC） , 1 case of carcinoma ex pleomorphic adenoma, and 1 case of epithelial-myoepithelial carcinoma （ EMC ）. Immunohistochemical EnVision method was used to detect the expression of S O X - 1 0 and G A T A - 3 in these tumor samples . Compare the expression of S O X - 1 0 and G A T A - 3 , analyze the value of S O X - 1 0 and G A T E - 3 used alone or in combination in diagnosis of malignant epithelial tumors of the salivary gland. Results Immunohistochemi-cal study showed that S O X - 1 0 was strongly diffuse positive expressed （3 ＋ ） in AciCC~,MASC~, EMC, positive rate was 100%; SOX-10 was moderate（2＋） to strong positive（3＋） expressed in 11 case of Ad- CC and 9 cases of myoepithelial carcinoma, positive rates were 91.7% and 90% ; GATA-3 was strongly diffuse positive expressed（ 3＋） in 1 case of carcinoma ex plemorphic, positive rate was 100%; CD117 was positive expressed in all AdCC and BCAC, with diffuse moderate（2＋） to strong （3 ＋ ） expression in adenoid cystic carcinoma. S-100 was strongly diffuse positive expressed in MASC. Conclusion As a measure of auxiliary diagnosis, the combined use of SOX-10, GATA-3 and other traditional immunological markers has some value in the differential diagnosis of malignant epithelial tumors of the salivary gland.