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GATA-3 immunohistochemistry in the differential diagnosis of adenocarcinoma of the urinary bladder.

GATA-3免疫组化检测用于膀胱腺癌的鉴别诊断

Ellis CL,Chang AG,Cimino-Mathews A,Argani P,Youssef RF,Kapur P,Montgomery EA,Epstein JI

Abstract

GATA-3 is a newly described marker that labels urothelial and breast carcinoma. However, no prior study has evaluated the expression of GATA-3 in primary bladder adenocarcinoma. Tissue microarrays (TMAs) containing 46 primary bladder adenocarcinomas were constructed. They contained 19 signet ring cell (SRC) and 27 conventional adenocarcinomas. Three additional cases of SRC using routine sections were included resulting in a total of 22 SRCs. In addition, TMAs containing 32 primary gastric signet ring adenocarcinomas and 36 primary lobular breast carcinomas were evaluated. The TMAs were subjected to immunohistochemical analysis for GATA-3, with nuclear labeling scored by intensity and percentage labeling. Breast and urothelial TMAs were also labeled for estrogen receptor, progesterone receptor, and gross cystic duct fluid protein. Diffuse nuclear GATA-3 labeling was seen in 9/22 (41.0%) SRCs and in 2/27 (7.0%) conventional adenocarcinomas (P=0.01). Extracellular mucin production was seen in 12 SRCs. One of 12 (8.0%) SRCs with extracellular mucin was GATA-3 positive, and 8/10 SRCs without extracellular mucin was GATA-3 positive (P=0.005). No nuclear GATA-3 labeling was seen in any gastric signet ring carcinoma. Diffuse, moderate to strong nuclear GATA-3 labeling was seen in 36/36 (100%) primary lobular breast carcinomas. Nuclear GATA-3 labeling is a useful marker for primary adenocarcinomas of the urinary bladder with signet ring features and can be helpful in distinguishing primary signet ring carcinomas of the urinary bladder from gastric signet ring carcinomas. GATA-3 is rarely positive in bladder adenocarcinomas that lack signet ring features and in SRCs displaying extracellular mucin production.

摘要

GAT-3是一种新阐明的用于尿路上皮肿瘤和乳腺肿瘤的标记。然而,目前尚未见在原发膀胱腺癌中GATA-3表达情况的研究。用46例膀胱原发腺癌的病例制作了组织芯片,其中有19例印戒细胞癌和27例普通腺癌病例。另外有3例印戒细胞癌的病例使用的是常规切片,因此共有22例印戒细胞癌。此外,还评估了由32例胃原发印戒细胞癌和36例原发于乳腺小叶癌组成的组织芯片。这些组织芯片均进行了GATA-3的免疫组化检测,对细胞核阳性的细胞根据阳性强度和百分比进行了评分。对乳腺和尿路上皮的组织芯片还进行了雌激素受体、孕激素受体和大囊性导管液体蛋白的免疫表型检测。在9/22(41.0%)例印戒细胞癌和2/27(7.0%)例普通腺癌中有弥漫性GATA-3的核阳性(P=0.01)。在12例印戒细胞癌中看到有细胞外粘液产物,其中1/12(8.0%)例伴有细胞外粘液产物的印戒细胞癌病例中有GATA-3的阳性,8/10例没有细胞外粘液的印戒细胞癌病例中有GATA-3的阳性表达(P=0.005)。在胃原发的印戒细胞癌中没有GATA-3的核阳性表达。在36/36(100%)例乳腺原发小叶癌中有弥漫性中-强的核阳性。对原发于膀胱并伴有印戒细胞特征的腺癌来说,GATA-3的核阳性是一个非常有用的标记,可以用来鉴别是膀胱原发的印戒细胞癌,还是胃印戒细胞癌的转移。而在没有印戒细胞特征的膀胱腺癌和伴有细胞外粘液产物的印戒细胞癌中,GATA-3罕见阳性。

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