CK7、CK20、Villin、CDX-2、MUC-2、PAX8在卵巢原发性黏液性肿瘤和继发性腹膜假黏液瘤中的表达及鉴别诊断意义

Expression of CK7,CK20,Villin,CDX-2,MUC-2 and PAX8 in primary ovarian mucinous neoplasms and secondary pseudomyxoma peritonei and their implications in differential diagnosis

目的探讨CK7、CK20、Villin、CDX-2、MUC-2、PAX8在卵巢原发性黏液性肿瘤(OPMN)和卵巢继发性腹膜假黏液瘤(OS-PMP)中的表达及鉴别意义。方法收集经组织学和临床资料证实的OPMN 22例,OS-PMP 31例,采用免疫组化EnVision两步法检测CK7、CK20、Villin、CDX-2、MUC-2、PAX8的表达。结果CK7、PAX8在OPMN中的阳性率显著高于OS-PMP(分别为100%vs.9.7%,63.6%vs.0)(P<0.01)。CK20、CDX2、MUC2在OSPMP中的阳性率显著高于OPMN(分别为100%vs.9.1%,100%vs.18.2%,100%vs.9.1%)(P<0.01)。Villin在OS-PMP中的阳性率显著高于OPMN(100%vs.68.2%)(P<0.05)。CK7、CK20、CDX-2、MUC-2在OS-PMP诊断中均具有较高的敏感性(分别为90.3%、100%、100%、100%)及特异性(分别为100%、90.9%、81.8%、90.9%)。而Villin、PAX8敏感度性(100%),但特异性较低(分别为31.8%、54.5%)。结论CK7、CK20、Villin、CDX-2、MUC-2、PAX8推荐用于任何临床或病理特征提示继发性起源的卵巢黏液性肿瘤。CK7、CK20、CDX-2、MUC-2是高度敏感性及特异性的免疫组化鉴别诊断标志物。

Objective To investigate the expression and differential significance of CK7,CK20,Villin,CDX-2,MUC-2 and PAX8 in ovarian primary mucinous neoplasms(OPMN)and ovarian secondary pseudomyxoma peritonei(OS-PMP).Methods A total of 22 OPMN and 31 OS-PMP confirmed by histological and clinical data were collected.The expression of CK7,CK20,Villin,CDX-2,MUC-2 and PAX8 was detected by immunohistochemical EnVision method.Results The expression of CK7 and PAX8 in OPMN was significantly higher than those in OS-PMP(100%vs.9.7%,63.6%vs.0,respectively)(P<0.01).The expression of CK20,CDX2 and MUC2 in OS-PMP was significantly higher than those in OPMN(100%vs.9.1%,100%vs.18.2%,100%vs.9.1%,respectively)(P<0.01).The expression of Villin in OSPMP was significantly higher than that of OPMN(100%vs.68.2%)(P<0.05).CK7,CK20,CDX-2 and MUC-2 showed high sensitivity(90.3%,100%,100%,100%,respectively)and specificity(100%,90.9%,81.8%,90.9%,respectively)in OS-PMP.Villin and PAX8 showed high sensitivity(100%)but low specificity(31.8%and 54.5%,respectively).Conclusion CK7,CK20,Villin,CDX-2,MUC-2 and PAX8 are recommended in the work-up of ovarian mucinous tumors with any clinical or pathological features suggestive of secondary origin.CK7,CK20,CDX-2 and MUC-2 are highly sensitive and specific immunohistochemical markers for the differential diagnosis.