TRPS1在唾液腺肿瘤中的表达及诊断价值

Expression and diagnostic value of TRPS1 in salivary gland tumors

目的:探讨转录抑制因子GATA结合基因1(transcriptional repressor GATA binding 1,TRPS1)在唾液腺良、恶性肿瘤中的表达及其在诊断、鉴别诊断中的价值。方法:回顾分析450例唾液腺良、恶性肿瘤的临床病理资料,利用免疫组化检测170例良性唾液腺肿瘤和280例恶性唾液腺肿瘤中TRPS1蛋白的表达情况,分析比较组织学形态有重叠的唾液腺肿瘤中TRPS1的表达差异,探索TRPS1在诊断、鉴别诊断中的价值。结果:TRPS1在正常腮腺腺泡细胞、腺管细胞表达阴性。在正常下颌下腺和舌下腺腺泡细胞、腺管细胞中,TRPS1为弱-中度或中度阳性。唾液腺良性肿瘤,多形性腺瘤TRPS1阳性率为82.86%,肌上皮细胞弥漫强阳性,腺上皮细胞及嗜酸性细胞为阴性或弱阳性。在基底细胞腺瘤中,TRPS1阳性率为8.00%,基底样细胞多为阴性或弱阳性,肿瘤间质细胞呈中度或高表达。Warthin瘤TRPS1均为阴性。唾液腺恶性肿瘤,癌在多形性腺瘤中,TRPS1在肌上皮癌亚型肿瘤细胞的表达高于腺癌亚型(85.00%vs.55.00%,P<0.05)。腺样囊性癌中TRPS1阳性率为93.33%,黏液表皮样癌中TRPS1阳性率为52.00%,透明细胞癌中TRPS1阳性率为6.67%,低级别分泌性癌中TRPS1阳性率为3.33%,腺泡细胞癌TRPS1阳性率仅33.33%。鉴别诊断由肌上皮细胞及腺上皮细胞构成的良性肿瘤,如多形性腺瘤和基底细胞腺,TRPS1在多形性腺瘤中表达高于基底细胞腺瘤(82.86%vs.8.00%,P<0.001),且TRPS1在后者的表达多位于间质细胞。腺样囊性癌和基底细胞腺瘤鉴别诊断,TRPS1在腺样囊性癌中的表达高于基底细胞腺瘤(93.33%vs.8.00%,P<0.001)。结论:TRPS1在正常唾液腺组织内低表达;唾液腺良性肿瘤中,多形性腺瘤中高表达,其他肿瘤类型表达较低;唾液腺恶性肿瘤,如癌在多形性腺瘤的肌上皮癌亚型和腺样囊性癌中,TRPS1呈高表达。TRPS1在不同类型唾液腺肿瘤中表达差异,对临床的鉴别诊断具有潜在价值。

Objective:To investigate the expression of transcriptional inhibitory factor GATA binding gene 1(TRPS1)in benign and malignant salivary gland tumors and its value in differential diagnosis.Methods:The clinicopathological data of 450 cases of benign and malignant salivary gland tumors were retrospectively analyzed, and the expression of TRPS1 in 170 cases of benign salivary gland tumors and 280 cases of malignant salivary gland tumors was detected by immunohistochemistry.The difference of TRPS1 expression in salivary gland tumors with overlapping histological morphology was analyzed and the application value of TRPS1 in differential diagnosis was also explored.Results:TRPS1 was negative in normal parotid acinar cells and glandular duct cells.TRPS1 was weak-moderate or moderately positive in normal submandibular gland and sublingual gland acinar cells and glandular duct cells.In benign salivary gland tumors, the positive rate of TRPS1 was 82.86% in pleomorphic adenoma, diffuse strong positive in myoepithelial cells, negative or weak positive in glandular epithelial cells and eosinophilic cells.In basal-cell adenomas, the positive rate of TRPS1 was 8.00%,basal-like cells were mostly negative or weakly positive, and stromal cells showed moderate or high expression.TRPS1 of Warthin tumors was negative.In salivary gland malignancies, cancer in pleomorphic adenomas, TRPS1 expression was higher in myoepithelial carcinoma subtype tumor cells than in adenocarcinoma subtype(85.00% vs.55.00%,P<0.05).In adenoid cystic carcinoma, the positive rate of TRPS1 was 93.33%.In mucoepidermoid carcinoma, the positive rate of TRPS1 was 52.00%.In clear cell carcinoma, the positive rate of TRPS1 was 6.67%.In low-grade secretory carcinoma, the positive rate of TRPS1 was 3.33%.In acinous cell carcinoma, the positive rate of TRPS1 was only 33.33%.In the differential diagnosis of benign tumors composed of myoepithelial cells and glandular cells, such as pleomorphic adenomas and basal cell glands, TRPS1 expression was higher in pleomorphic adenomas than in basal cell adenomas(82.86% vs.8.00%,P<0.001),and TRPS1 expression in the latter was mostly located in stromal cells.In the differential diagnosis of adenoid cystic carcinoma and basal cell adenoma, TRPS1 expression was higher in adenoid cystic carcinoma than in basal cell adenoma(93.33% vs.8.00%,P<0.001).Conclusion:TRPS1 was low expressed in normal salivary gland tissues.In benign salivary gland tumors, the expression was high in pleomorphic adenoma and low in other tumor types.In salivary gland malignancies, such as carcinomas in the myoepithelial carcinoma subtype of pleomorphic adenomas and adenoid cystic carcinomas, TRPS1 is highly expressed.The expression of TRPS1 is different in different types of salivary gland tumors, which has potential value for clinical differential diagnosis.