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Nuclear Localization of β-Catenin in Sertoli Cell Tumors and Other Sex Cord-Stromal Tumors of the Testis: An Immunohistochemical Study of 87 Cases.

睾丸支持细胞瘤和其他性索间质肿瘤β-Catenin核表达:87例免疫组化研究

Abstract

The diagnosis and subclassification of Sertoli cell tumors (SCT) of the testis are often challenging to general surgical pathologists because of the rarity of the tumors. Immunohistochemical study to date has limited diagnostic value. Nuclear localization of β-catenin, which correlated closely with CTNNB1 gene mutation, was recently reported in SCTs. We investigated the utility of β-catenin nuclear localization in diagnosing SCTs and differentiating them from other testicular sex cord-stromal tumors. Immunohistochemical staining for β-catenin was evaluated in 87 cases of testicular sex cord-stromal tumor: 33 SCTs, not otherwise specified (SCT-NOS) (15 with benign and 18 with malignant features), 10 sclerosing SCTs (SSCT), 5 large cell calcifying SCTs (LCCSCT), 6 Sertoli-stromal cell tumors, 10 Leydig cell tumors, 7 juvenile granulosa cell tumors, 4 adult granulosa cell tumors, and 12 sex cord-stromal tumors, unclassified. Twenty-one of 33 (64%) SCT-NOS, 6 of 10 (60%) SSCTs, and 4 of 6 (67%) Sertoli-stromal cell tumors showed strong, diffuse β-catenin nuclear staining. Nuclear β-catenin positivity was more frequent in SCTs-NOS with benign features than in those with malignant features (93% and 39%, respectively, P=0.13) and, in the Sertoli-stromal cell tumors, occurred only in the Sertoli component. All 5 LCCSCTs and all other types of sex cord-stromal tumor were negative for β-catenin nuclear staining. In conclusion, SCT-NOS and SSCT frequently show β-catenin nuclear localization. Positive nuclear staining of β-catenin is specific for SCT-NOS, SSCT, and Sertoli-stromal cell tumor among testicular sex cord-stromal tumors but has limited sensitivity (63%) in this group. The similar reactivity of SCT-NOS and SSCT provides additional support that these 2 variants are not distinct entities.

摘要

由于相对罕见,睾丸支持细胞肿瘤(SCT)的诊断和分型对普通外科病理医生而言常常是具有挑战性的。目前对其免疫组化诊断价值的研究有限。最近报道了SCT存在与CTNNB1基因突变密切相关的β-Catenin核表达。我们探索了β-Catenin核表达对SCT诊断及其与其他睾丸性索间质肿瘤鉴别诊断的价值。87例睾丸性索间质肿瘤,包括33例SCT非特殊类型(SCT-NOS)(15例良性和18例恶性特征)、10例硬化型SCT(SSCT)、5例大细胞钙化型SCT(LCCSCT)、6例支持间质细胞肿瘤、10例Leydig细胞肿瘤、7例幼年型颗粒细胞瘤、4例成人型颗粒细胞瘤和12例性索间质肿瘤未能分类型,对其进行了β-Catenin免疫组化染色。21/33例(64%)SCT-NOS、6/10例(60%)SSCT和4/6例(67%)支持间质细胞肿瘤呈β-Catenin弥漫性核强阳性。β-Catenin核阳性在伴有良性特征的SCT-NOS比伴有恶性的SCT-NOS更常见(分别为93%和39%,P=0.13),在支持间质细胞肿瘤,阳性仅偶见于支持细胞成分。所有5例LCCSCT和其他类型性索间质瘤均为β-Catenin核阴性。总之,SCT-NOS和SSCT常常显示β-Catenin核阳性。β-Catenin核阳性对SCT-NOS、SSCT和睾丸性索间质肿瘤中的支持间质细胞肿瘤是特异性的,但灵敏度有限(63%)。SCT-NOS和SSCT有相似的阳性反应提供了另外一种证据,表明这2种病变不是不同实体。
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