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GATA3 Immunohistochemistry for Distinguishing Sarcomatoid and Desmoplastic Mesothelioma From Sarcomatoid Carcinoma of the Lung.

GATA3免疫组化用于区分肉瘤样/促结缔组织增生性间皮瘤与肺肉瘤样癌

Abstract

The separation of sarcomatoid and desmoplastic malignant mesotheliomas from sarcomatoid carcinomas of the lung metastatic to the pleura may be difficult, since both types of tumor can be morphologically similar and are frequently positive only for pan-keratin. GATA binding protein 3 (GATA3) is most commonly used as an immunohistochemical marker of breast and urothelial carcinoma, but is also known to stain other types of tumors including some mesotheliomas. In this study we asked whether GATA3 stains could be used to distinguish sarcomatoid/desmoplastic malignant mesotheliomas (N=19) from sarcomatoid carcinomas of the lung (N=13). Tumor staining was scored for diffuseness and intensity, with a maximum possible score of 6. All 19 sarcomatoid/desmoplastic malignant mesotheliomas examined showed strong diffuse staining for GATA3 (no case scored <3, mean score±SD for all 19 cases 5.4±0.9), whereas only 2 of 13 sarcomatoid carcinomas of the lung stained positively for GATA3 and the staining was weak and patchy (score 2 for each case, mean±SD for all 13 cases 0.4±0.8). There was no correlation between the intensity and diffuseness of GATA-3 staining and staining for traditional mesothelioma markers. Overall, any positive staining for GATA3 was 100% sensitive and 85% specific for sarcomatoid/desmoplastic mesothelioma. We conclude that strong diffuse staining for GATA3 favors a diagnosis of sarcomatoid/desmoplastic malignant mesothelioma over metastatic sarcomatoid carcinoma of the lung; conversely, complete absence of GATA-3 staining is evidence against a diagnosis of sarcomatoid/desmoplastic malignant mesothelioma.

摘要

鉴别肉瘤样/促结缔组织增生性恶性间皮瘤与肺肉瘤样癌转移至胸膜可能很困难,因为二者形态学非常相似,并且通常仅仅阳性表达广谱细胞角蛋白(CKpan)。GATA结合蛋白3GATA3)是最常用于乳腺癌和尿路上皮癌的免疫标记物,但也可以标记其他类型肿瘤,包括一些间皮瘤。本研究旨在探讨GATA3标记能否用于鉴别肉瘤样/促结缔组织增生性恶性间皮瘤(N=19)与肺肉瘤样癌(N=13)。肿瘤着色评分以弥漫程度和染色强度来综合评估,最高6分。19例肉瘤样/促结缔组织增生性恶性间皮瘤显示弥漫强烈阳性表达 GATA3 (无例小于3分,平均分±SD5.4±0.9),而仅2/13肺肉瘤样癌GATA3呈微弱或斑片状阳性(2例分值均为2分,13例平均分±SD0.4±0.8)。GATA3染色强度和弥漫程度与传统间皮瘤标记物无相关性。总的来说,GATA3标记在肉瘤样/促结缔组织增生性恶性间皮瘤中敏感性为100%,特异性为85%。作者得出结伦是:GATA3弥漫强阳性支持肉瘤样/促结缔组织增生性恶性间皮瘤的诊断,而不是肺转移性肉瘤样癌;相反GATA3表达完全缺失,则不支持诊断肉瘤样/促结缔组织增生性恶性间皮瘤。

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