INSM1在嗜铬细胞瘤/副神经节瘤和肾上腺皮质腺瘤中的表达和病理诊断价值  

Expression of INSM1 in pheochromocytoma/paraganglioma and adrenocortical adenoma and its pathological diagnostic value

作　　者：白琳琳 王鹏[1] 徐洪涛[2] BAI Linlin;WANG Peng;XU Hongtao(Department of Pathology,the 242 Hospital of Shenyang Medical College,Shenyang 110034,China;Department of Pathology,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]沈阳医学院附属二四二医院病理科,沈阳110034 [2]中国医科大学附属第一医院病理科,沈阳110001

出　　处：《临床与实验病理学杂志》2024年第4期391-395,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨胰岛素瘤相关蛋白1(insulinoma-associated protein 1,INSM1)在嗜铬细胞瘤/副神经节瘤和肾上腺皮质腺瘤中的表达及其在鉴别诊断中的意义。方法采用免疫组化EnVision两步法检测INSM1在嗜铬细胞瘤/副神经节瘤和肾上腺皮质腺瘤中的表达。结果32例嗜铬细胞瘤中31例INSM1阳性(31/32,96.88%),其中高表达20例(20/32,62.50%)。9例肾上腺外副神经节瘤INSM1均阳性,其中高表达8例(8/9,88.89%)。33例肾上腺皮质腺瘤中INSM1均阴性。INSM1在嗜铬细胞瘤/副神经节瘤中的表达显著高于肾上腺皮质腺瘤(P<0.001)。INSM1高表达的嗜铬细胞瘤/副神经节瘤具有更高的Ki67增殖指数(P=0.016),但与患者性别(P=0.190)、年龄(P=0.439)、肿瘤TNM分期(P=0.793)、生长模式(P=0.495)、凝固性坏死(P=0.790)和脉管/包膜侵犯(P=0.790)均无显著相关性。INSM1鉴别嗜铬细胞瘤/副神经节瘤与肾上腺皮质腺瘤的敏感性为97.6%,特异性为100%,ROC曲线下面积为0.988。结论INSM1表达于嗜铬细胞瘤和副神经节瘤的细胞核,而不表达于肾上腺皮质腺瘤,可有效鉴别嗜铬细胞瘤/副神经节瘤和肾上腺皮质腺瘤。Purpose To investigate the expression of insulinoma-associated protein 1(INSM1)in pheochromocytoma/paraganglioma and adrenocortical adenoma,and its significance in differential diagnosis.Methods Immunohistochemical EnVision two-step method was used to detect the expression of INSM1 in pheochromocytoma/paraganglioma and adrenocortical adenoma.Results In 32 cases of pheochromocytoma,31 cases were positive for INSM1(31/32,96.88%),of which INSM1 was highly expressed in 20 cases(20/32,62.50%).Nine cases of extraadrenal paraganglioma were all positive for INSM1,of which INSM1 was highly expressed in 8 cases(8/9,88.89%).The expression of INSM1 was negative in 33 cases of adrenocortical adenoma.The expression rate of INSM1 in pheochromocytoma/paraganglioma was significantly higher than that in adrenocortical adenoma(P<0.001).The expression level of INSM1 was positively associated with Ki67 index(P=0.016),but not correlated with gender(P=0.190),age(P=0.439),TNM stage(P=0.436),growth pattern(P=0.495),coagulation necrosis(P=0.790),and vascular/capsule invasion(P=0.790).The sensitivity of INSM1 in differentiating pheochromocytoma/paraganglioma from adrenocortical adenoma was 97.6%,and the specificity was 100%.The area under the receiver operating characteristic(ROC)curve was 0.988.Conclusion INSM1 is expressed in the nuclei of pheochromocytoma/paraganglioma,but not expressed in adrenocortical adenoma.So,INSM1 can be used as an effective marker to distinguish pheochromocytoma/paraganglioma from adrenocortical adenoma.

关 键 词：嗜铬细胞瘤 副神经节瘤 肾上腺皮质腺瘤 INSM1 

分 类 号：R736.6[医药卫生—肿瘤]