SOX-11及TFE3在胰腺实性假乳头状肿瘤中的表达及其临床意义  

Expression of SOX-11 and TFE3 in solid-pseudopapillary tumor of pancreas and its clinical significance

作　　者：王娅 付尧[1] 郑重[1] 吴鸿雁[1] 周强[1] 陈孔龄 陶钰 濮晓红 丁杰[1] 王婷[1] 史炯[1] 樊祥山[1] Wang Ya;Fu Yao;Zheng Zhong;Wu Hongyan;Zhou Qiang;Chen Kongling;Tao Yu;Pu Xiaohong;Ding Jie;Wang Ting;Shi Jiong;Fan Xiangshan(Department of Pathology,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院病理科,210008

出　　处：《中华病理学杂志》2020年第10期1036-1040,共5页Chinese Journal of Pathology

基　　金：“十三五”南京市卫生青年人才培养工程第一层次人才项目(ZKX17004);南京医学科技发展项目(QRX17013)。

摘　　要：目的探讨SRY相关的高迁移率组盒蛋白-11(SOX-11)及转录因子E3(TFE3)在胰腺实性假乳头状肿瘤(SPTP)中的表达情况及其在鉴别诊断中的价值。方法收集南京鼓楼医院病理科2012-2019年间38例SPTP,36例胰腺神经内分泌肿瘤(PanNET)和6例胰腺腺泡细胞癌(PACC)患者资料,采用免疫组织化学EnVision法检测SOX-11、TFE3及β-catenin的表达情况,采用荧光原位杂交(FISH)法检测18例SPTP中TFE3基因重排情况。结果38例SPTP患者中,女性29例,男性9例,平均年龄50岁;36例PanNET患者中,女性32例,男性4例,平均年龄39岁;PACC患者6例,男性4例,女性2例,发病平均年龄60岁。38例SPTP均为β-catenin阳性,36例PanNET均为β-catenin阴性,5/6例PACC为β-catenin阴性;35/38(92.1%)SPTP为SOX-11阳性,36例PanNET及6例PACC均为SOX-11阴性;36/38(94.7%)SPTP为TFE3阳性,36例PanNET及6例PACC均为TFE3阴性。β-catenin的特异度与灵敏度分别为97.6%和100.0%,SOX-11的特异度与灵敏度分别为92.1%和100%,TFE3的特异度与灵敏度分别为94.7%和100.0%。三种抗体在SPTP、PanNET、PACC中的表达差异有统计学意义(P<0.01),且SOX-11、TFE3检测结果具有较高的一致性(Kappa>0.6);SPTP中并未检出TFE3基因重排(0/18)。结论SOX-11和TFE3在SPTP中高表达,且二者在SPTP鉴别诊断中的特异度优于β-catenin。Objective To investigate the expression status and diagnostic value of SRY related high mobility group box 11(SOX-11)and transcription factor E-3(TFE3)in solid pseudopapillary tumors of pancreas(SPTPs).Methods Thirty-eight cases of SPTPs,36 cases of well-differentiated pancreatic neuroendocrine tumors(PanNETs)and six cases of pancreatic acinar cell carcinomas(PACCs)were collected at the Affiliated Drum Tower Hospital of Nanjing University Medical School from 2012 to 2019.The expression of SOX-11,TFE3 andβ-catenin was detected by immunohistochemistry,and the TFE3 gene status was detected by FISH in 18 cases of SPTPs.Results Among the 38 SPTP patients,29 were female and 9 were male,with a mean age of 50 years;among 36 PanNET patients,32 were female and 4 were male,with a mean age of 39 years;for the six PACC patients,four were male and two were female,with a mean age of 60 years.β-catenin was positive in all 38 SPTPs,but was negative in all 36 PanNETs and 5/6 PACCs.SOX-11 was positive in 35/38(92.1%)of SPTPs,but was negative in all 36 PanNETs and 6 PACCs.TFE3 was positive in 36/38(94.7%)of SPTPs,but was negative in all 36 PanNETs and 6 PACCs.Among these three tumors,the specificity and sensitivity ofβ-catenin were 97.6%and 100.0%,the specificity and sensitivity of SOX-11 were 92.1%and 100.0%,the specificity and sensitivity of TFE3 were 94.7%and 100.0%,respectively.There was a significant difference of the expression status of all three markers in SPTPs compared with PanNETs and PACCs(P<0.01).The results of SOX-11 and TFE3 immunostaining showed high consistency(Kappa>0.6).No gene rearrangement(0/18)of TFE3 was found in SPTPs.Conclusion SOX-11 and TFE3 are highly expressed in SPTPs,and their specificity in the differential diagnosis of SPTPs is better than that ofβ-catenin.

关 键 词：胰腺肿瘤 SOXC转录因子 诊断 鉴别 实性假乳头状肿瘤 TFE3 

分 类 号：R737.35[医药卫生—肿瘤]