title: A novel monoclonal antibody against DOG1 is a sensitive and specific marker for gastrointestinal stromal tumors.
abstract: Gastrointestinal stromal tumors (GIST) occur primarily in the wall of the intestine and are characterized by activating mutations in the receptor tyrosine kinases genes KIT or PDGFRA. The diagnosis of GIST relies heavily on the demonstration of KIT/CD117 protein expression by immunohistochemistry. However, KIT expression is absent in approximately 4% to 15% of GIST and this can complicate the diagnosis of GIST in patients who may benefit from treatment with receptor tyrosine kinase inhibitors. We previously identified DOG1/TMEM16A as a novel marker for GIST using a conventional rabbit antipeptide antiserum and an in situ hybridization probe. Here, we describe 2 new monoclonal antibodies against DOG1 (DOG1.1 and DOG1.3) and compare their staining profiles with KIT and CD34 antibodies on 447 cases of GIST. These included 306 cases with known mutational status for KIT and PDGFRA from a molecular consultation service. In addition, 935 other mesenchymal tumors and 432 nonsarcomatous tumors were studied. Both DOG1 antibodies showed high sensitivity and specificity for GIST, with DOG1.1 showing some advantages. This antibody yielded positive staining in 370 of 425 (87%) scorable GIST, whereas CD117 was positive in 317 of 428 (74%) GIST and CD34 in 254 of 430 (59%) GIST. In GIST with mutations in PDGFRA, 79% (23/29) showed DOG1.1 immunoreactivity while only 9% (3/32) and 27% (9/33) stained for CD117 and CD34, respectively. Only 1 of 326 (0.3%) leiomyosarcomas and 1 of 39 (2.5%) synovial sarcomas among the 935 soft tissue tumors examined showed positive immunostaining for DOG1.1. In addition, DOG1.1 immunoreactivity was seen in fewer cases of carcinoma, melanoma, and seminoma as compared with KIT.
authors.affiliation: Department of Pathology, Stanford University Medical Center, Stanford, CA 94305, USA.
authors.forename: Inigo
authors.initials: I
authors.lastname: Espinosa
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Lee
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Kim
authors.forename: Bich-Tien
authors.initials: BT
authors.lastname: Rouse
authors.forename: Subbaya
authors.initials: S
authors.lastname: Subramanian
authors.forename: Kelli
authors.initials: K
authors.lastname: Montgomery
authors.forename: Sushama
authors.initials: S
authors.lastname: Varma
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Corless
authors.forename: Michael C
authors.initials: MC
authors.lastname: Heinrich
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Smith
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
authors.forename: Brian
authors.initials: B
authors.lastname: Rubin
authors.forename: Torsten O
authors.initials: TO
authors.lastname: Nielsen
authors.forename: Robert S
authors.initials: RS
authors.lastname: Seitz
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Ross
authors.forename: Robert B
authors.initials: RB
authors.lastname: West
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cleary
authors.forename: Matt
authors.initials: M
authors.lastname: van de Rijn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075369:Anoctamin-1; D000911:Antibodies, Monoclonal / Q000276:immunology*; D018952:Antigens, CD34 / Q000276:immunology; D014408:Biomarkers, Tumor / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D018118:Chloride Channels; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008565:Membrane Proteins / Q000276:immunology*; D008875:Middle Aged; D009154:Mutation; D009363:Neoplasm Proteins / Q000276:immunology*; D019009:Proto-Oncogene Proteins c-kit / Q000276:immunology; D020796:Receptor, Platelet-Derived Growth Factor alpha / Q000235:genetics; D012680:Sensitivity and Specificity
chemical_list: C476213:ANO1 protein, human; D000075369:Anoctamin-1; D000911:Antibodies, Monoclonal; D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D018118:Chloride Channels; D008565:Membrane Proteins; D009363:Neoplasm Proteins; D019009:Proto-Oncogene Proteins c-kit; D020796:Receptor, Platelet-Derived Growth Factor alpha