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Cadherin 17 is a sensitive and specific marker for metanephric adenoma.

钙粘连蛋白17是后肾腺瘤的敏感和特异性标记物

Yakirevich E,Magi-Galluzzi C,Grada Z,Lu S,Resnick MB,Mangray S

Abstract

Metanephric adenoma (MA) is a rare benign renal neoplasm that shares morphologic and immunophenotypic overlap with epithelial-predominant Wilms tumor (e-WT) and with the solid variant of papillary renal cell carcinoma (s-PRCC). Cadherin 17 (CDH17) is expressed primarily in the normal intestine and digestive tract tumors and has not been detected in tumors from other sites including the kidney. We investigated the diagnostic utility of CDH17 in differentiating between MA, e-WT, and s-PRCC. Immunohistochemical analysis for CDH17, CD57, AMACR, WT-1, and CDX2 was performed on 17 e-WTs, 15 s-PRCCs, and 21 MAs and assessed on the basis of a combined score of extent and intensity. Normal adult kidney parenchyma was negative for CDH17 staining. CDH17 was expressed in the late stages of fetal kidney development at the junction of the glomerular space and proximal nephron. The majority of MAs (81%) demonstrated membranous CDH17 immunoreactivity in all components (acinar, tubular, and papillary), whereas all cases of e-WTs and s-PRCCs were negative (P<0.0001). WT-1 was negative in s-PRCC and was positive in all cases of e-WT and MA. All MAs were strongly positive for CD57; however, this marker was also moderate to strongly positive in 6 (35%) e-WTs and 2 (13%) s-PRCCs. AMACR was strongly positive in all s-PRCCs, but moderate reactivity was seen in 3 (17%) e-WTs and 2 MAs (10%). CDH17 is a sensitive (81%) and highly specific (100%) marker for MA and should be considered in the immunohistochemistry panel for distinguishing MA from its mimics.

摘要

后肾腺瘤(MA)是一种少见良性肾肿瘤,其形态学与免疫表型与上皮为主型肾母细胞瘤(e-WT)和实体型乳头状肾细胞癌(s-PRCC)有重叠。钙粘连蛋白 17(CDH17)主要表达于正常小肠和消化道肿瘤,尚未在包括肾在内的其他部位肿瘤中发现其表达。我们研究了CDH17在鉴别诊断MA、e-WT和s-PRCC中的实用价值。应用CDH17、CD57、AMACR、WT-1和CDX2对17例e-WT、15例s-PRCC、21例MA进行免疫组化分析,并以染色强度及范围的综合评分为基础进行评价。正常成人肾实质CDH17染色阴性。CDH17表达于发育晚期胚胎肾的肾小球腔与近端肾单位的连接处。大多数(81%)后肾腺瘤的所有成分(腺泡、腺管和乳头)显示CDH17膜阳性,而所有的e-WTs和s-PRCC均阴性(P<0.0001)。 WT-1染色在s-PRCC为阴性,而在所有e-WT和MA病例中都阳性。所有MA CD57强阳性表达;但是6例(35%)e-WT和2例(13%)s-PRCC也呈中等到强的阳性。所有s-PRCC都强阳性表达AMACR,但3例(17%)e-WT和2例(10%)MA也中度表达。CDH17是一个敏感(81%)和高度特异(100%)的后肾腺瘤标记物,在MA与类似肿瘤鉴别时的免疫组化套餐中应包含CDH17。

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