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GATA3: A Multispecific But Potentially Useful Marker in Surgical Pathology: A Systematic Analysis of 2500 Epithelial and Nonepithelial Tumors.

GATA3:一种有用的、多部位特异性的病理诊断标记,来自一项2500例上皮及非上皮来源肿瘤的系统研究。

Miettinen M,McCue PA,Sarlomo-Rikala M,Rys J,Czapiewski P,Wazny K,Langfort R,Waloszczyk P,Biernat W,Lasota J,Wang Z

Abstract

GATA3 is a transcription factor important in the differentiation of breast epithelia, urothelia, and subsets of T lymphocytes. It has been suggested to be useful in the evaluation of carcinomas of mammary or urothelial origin or metastatic carcinomas, but its distribution in normal and neoplastic tissues is incompletely mapped. In this study, we examined normal developing and adult tissues and 2040 epithelial and 460 mesenchymal or neuroectodermal neoplasms for GATA3 expression to explore its diagnostic value in surgical pathology, using monoclonal antibody (clone L50-823) and Leica Bond automated immunohistochemistry. GATA3 was expressed in trophoblast, fetal and adult epidermis, adult mammary and some salivary gland and sweat gland ductal epithelia, urothelia, distal nephron in developing and adult tissues, some prostatic basal cells, and subsets of T lymphocytes. It was expressed stronger in fetal than in adult mesothelia and was absent in respiratory and gastrointestinal epithelia. In epithelial neoplasms, GATA3 was expressed in >90% of primary and metastatic ductal and lobular carcinomas of the breast, urothelial, and cutaneous basal cell carcinomas and trophoblastic and endodermal sinus tumors. In metastatic breast carcinomas, it was more sensitive than GCDFP. Among squamous cell carcinomas, the expression was highest in the skin (81%) and lower in cervical (33%), laryngeal (16%), and pulmonary tumors (12%). Common positivity was found in skin adnexal tumors (100%), mesothelioma (58%), salivary gland (43%), and pancreatic (37%) ductal carcinomas, whereas frequency of expression in adenocarcinomas of lung, stomach, colon, endometrium, ovary, and prostate was <10%. Chromophobe renal cell carcinoma was a unique renal tumor with frequent positivity (51%), whereas oncocytomas were positive in 17% of cases but other types only rarely. Among mesenchymal and neuroectodermal tumors, paragangliomas were usually positive, which sets these tumors apart from epithelial neuroendocrine tumors. Mesenchymal tumors were only sporadically positive, except epithelia of biphasic synovial sarcomas. GATA3 is a useful marker in the characterization of not only mammary and urothelial but also renal and germ cell tumors, mesotheliomas, and paragangliomas. The multiple specificities of GATA3 should be taken into account when using this marker to detect metastatic mammary or urothelial carcinomas.

摘要

GATA3是一种在乳腺上皮、尿路上皮及T淋巴细胞亚型分化过程中起重要作用的转录因子。GATA3在判断原发或转移性乳腺癌及尿路上皮癌的诊断中非常重要,但是其在其他正常组织及肿瘤组织中的表达至今还不明确。本研究中,我们对发育中及成人的2040例正常上皮组织及上皮源性肿瘤及460例间叶组织或神经外胚叶来源肿瘤进行了GATA3表达分析,以明确其在病理诊断中的价值。研究中使用的GATA3抗体为单克隆抗体(克隆号L50-832),用徕卡自动免疫组化系统进行检测。结果表明GATA3在滋养叶细胞、胎儿及成人的表皮、成人乳腺、部分涎腺及汗腺导管上皮、尿路上皮、发育中及成人的远端肾单位、部分前列腺基底细胞和各种T淋巴细胞亚型中均有表达。胎儿间叶组织中GATA3的表达比在成人中的表达强,在呼吸道和消化道上皮中不表达。在上皮源性肿瘤中,90%以上的原发和转移性乳腺导管癌及乳腺小叶癌、尿路上皮癌、皮肤基底细胞癌、滋养层细胞肿瘤和内胚窦瘤中有GATA3表达。在转移性乳腺癌的诊断中,GATA3比GCDFP更敏感。GATA3在皮肤的鳞状细胞癌中表达最高(81%),而在宫颈部的鳞状细胞癌(33%)、喉部鳞状细胞癌(16%)及肺鳞状细胞癌(12%)中的表达较低。通常GATA3在皮肤附属器肿瘤(100%)、间皮瘤(58%)、涎腺导管癌(43%)以及胰腺导管癌(37%)中均有不同程度表达。而在来源于肺、胃、结肠、子宫内膜、卵巢和前列腺的腺癌中的表达常低于10%。在肾脏嫌色细胞癌中的表达为51%,嗜酸细胞腺瘤中的表达为17%,而在其他类型的肾脏肿瘤中很少表达。在间叶组织来源及神经外胚叶来源的肿瘤中,副神经节瘤通常阳性,这表明该类肿瘤不同于上皮性神经内分泌肿瘤。间叶组织来源肿瘤中只有双相滑膜肉瘤中的上皮成分阳性,其余仅散在阳性。GATA3不仅在乳腺、尿路上皮来源的肿瘤诊断中意义非凡,而且在肾脏、生殖细胞肿瘤、间皮瘤和副神经节瘤的诊断中也有重要的作用。故,在用GATA3鉴别原发或转移性乳腺癌或尿路上皮癌的同时,要注意考虑到GATA3的多部位特异性的特点。

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